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Imperial Physician 


Explaining the Method and Technique 
of Administering Boiled China Root 
Which the Invincible Charles V 
Recently Employed 

And Summarizing 
Among Other Things 

The Substance of an Epistle to Jacobus Sylvius 
That is of Great Usefulness 
To Students of the Truth, 

Especially of the Human Fabric; 

Since it Shows How Easily Galen 
Has Heretofore Been 
Excessively Trusted on That Subject. 

There is Also Attached to This Epistle 
An Index of Important Subjects and Words 


From the Press of Joannes Oporinus 
In the Year of Human Salvation 

In the Month of October 


Dedicatory Preface by F ranciscus Vesalius — 3 
Author’s Greeting to Joachim Roelants 
- II 

Occasion forWriting about the China Root — 12 
With What Success Many Have Used the China —12 
Description of the China Root —18 
Method of Preparing the China Decoction — 23 
Quantity of the First China Decoction to be 
Administered, and the Time to Give It — 24 
How a Sweat Should Be Induced — 25 
What Drink Is Useful — 29 
Sleep and Wakefulness — 29 
Movement and Rest —30 
Concern about Bodily Wastes — 30 
What Affects of the Mind Are Applicable — 31 
Sexual Activity — 31 

How Long the First Decoction Should Be Used — 32 


A Method of Preparing and Taking a Second 
Decoction — 33 

A Way of Administering Sparta Parilla —34 
Native and Familiar Drugs Should Be Put to Use 
Rather Than Exotics — 36 
Decoction of Chamaedrys — 36 
No Small Results Can Be Expected from Genuine 
Rhapontic — 37 

Flapless People Who Gratify Themselves by Publishing 
Something —40 

Occasion for the Letter of Sylvius in Which It Was 
Declared That Nothing Written by Galen Is 
Completely in Error —41 

Occasion for the Opinion, Here to Be Recorded, of 
the Letter in Which Vesalius Replied to Sylvius — 45 
Galen Did Not Dissect FI uni an s, But Teaches the Study 
of Animals Instead of Man — 46 
A Number of Conjectures from the Bones — 46 
[Sutures of the Skull] — 47 
[Foramina of the Skull] — 47 
[Condyles of the Occiput] — 47 
[Midline of the Mandible] — 48 
[Flyoid Bone] - 48 

[Seventh CervicalVertebra: Perforation of 
Transverse Processes] — 48 
[Tenth Thoracic Vertebra] — 48 
[Processes of the Lower Vertebrae] — 49 
[Bones of the Sacrum and Coccyx] — 49 
[The Shape of the FI urn an Sternum] — 52 
[The Fetal Urachus] - 53 
[Bony Rib Cartilages] — 53 
[Whether the Human Heart Has a Bone] — 53 


[Joint of the Clavicle with the Acromion] — 53 
[The os pisiforme and the ramus palmaris 
nervi ulnaris\ — 54 

Conclusions Drawn about the Fat, Muscles, and 
Ligaments, Whereby It Is Concluded That Galen 
Did Not Describe the Human Fabric — 55 
[Subcutaneous Fat and the Fleshy 
Membrane] — 56 

[A Muscle Adducting the Arm to the Chest in 
Caudate Apes] — 57 

[A Simian Muscle Raising the Scapula] — 57 
[The m. levator scapulae] — 58 
[Two Muscles of the Head and Neck] - 58 
[The Second Pair of Muscles Moving the 
Head] - 59 

[Muscles Moving the Thorax] — 59 
[Lumbar Muscles] — 60 
[The Tendon Hidden in the Hand] — 60 
[Muscles that Extend the Forearm] — 62 
[The Biceps Brachii Muscle] — 62 
[Muscles Moving the Tibia] — 63 
[The Tendon Beneath the Sole of the Foot] — 64 
[The Tendon of the First Two Tendons Moving 
the Foot] — 65 

[The Tendon of the Soleus Muscle] — 65 
[Three Muscles in the Back of the Tibia] — 65 
[The Sixth Muscle Moving the Foot] — 66 
[A Flexor of the Toes] — 66 
[Extensor Muscles of the Toes] — 68 
Several Places Taken from the Series of Veins and 

Arteries in Which It Is Inferred That Galen Did Not 
Dissect Humans — 69 

[Veins to the Stomach and the Spleen] — 69 
[Course of the Vena Cava Through the 
Thorax] — 70 

[Course of the Vena Cava Through the Transverse 
Septum] — 71 

[Procedures in Bloodletting] — 71 
[Origin of the UnpairedVein] — 72 
Galen Did Not See the Inner Veins That Hide Deep in 
the Human Arm —74 

[Origin of the Humeral Vein] — 75 
[Further Disputes about the Veins of the 
Arm] — 76 

Reasons Taken from the Nerves by Which It Is Known 
That Humans Were Not Dissected by Galen — 77 
Reasons Selected from the Contents of the 
Peritoneum —78 

[Connection from the Omentum to the 
Colon] - 79 

[Curvature and Course of the Colon] — 81 
[Construction of the Liver] — 81 
[Two Ligaments Attached to the Liver] — 82 
[Connection of the Bladder to the 
Peritoneum] — 82 
[The Site of the Spleen] — 83 
[The Structure of the Penis] — 83 
[The Uterus] -84 

[Vessels Inserted into the Neck of the 
Bladder] — 87 
[Vessels to the Uterus] — 87 
[Size of the Uterus; Length of the Vagina] — 88 
[Bovine vs. Human Uterus] — 88 
[Uterine Acetabula] - 89 
[Fetal Acetabula] — 90 

Some Conjectures Based upon the Parts That Are 
Contained in the Thorax — 90 

[The Fifth Lobe of the Lung in Galen] — 91 
[The Wrapping of the Heart; Position of the 
Heart] -91 

Reasons Taken from Those Contained in the 
Skull - 92 

[Position of the Cerebellum] — 92 
Some Places Where Galen Openly Criticized the 
Ancients Because They Had Dissected Humans and 
Not Apes, as He Did — 93 
Not Everything in His Description of the Parts Was 
Correctly Reported and Described by Galen — 95 
A Number of Untrue Descriptions in the Bones — 96 
[Errors of Galen in Describing Joints] — 91 
[The Ethmoid Bone of the Head] — 98 
[The Gland That Receives Cerebral 
Phlegm] — 99 

[Depressions and Protrusions in the Skull 
Cavity] — 99 

[No Bone in the Human Cerebrum] — 99 
[Bones in the Tympanic Cavity] — 100 
[Roots of the Teeth] — 100 
[Foramen for the Optic Nerve] —100 
[The Reticular Plexus] —101 
[Foramen for the Carotid Artery] — 101 
[Composition of the Upper Maxilla] —101 
[Course and Naming of Skull Sutures] —102 
[Ossicles of the Hyoid Bone] —102 
[Distinction Between Thoracic and Cervical 
Vertebrae] -102 

[Attachment of Ribs to Vertebrae] —102 
[The Fibula Is Longer than the Humerus] —103 


[Tubercles at the End of the Humerus] — 103 
[Articulation of the Wrist with the 
Lower Arm] —103 
[Cartilage at the Wrist] -104 
[Similar Cartilaginous Coatings] —105 
[Shape of the Digital Bones] —105 
[Variations in Joints of the Fingers] —105 
[Muscle Insertions in the Digital Bones] —106 
[Galen’s Failure to Find Sesamoid Bones] —106 
[Sockets in the Tibia for the Femur] — 106 
[The Human Foot Compared to Feet of Other 
Animals] —107 

[Articulation of the Tibia to the Talus in 
Quadrupeds] -108 

[Comparative Anatomy of the Elbow Joint] —109 
[Comparative Anatomy of the Foot] —109 
Several Inaccurate Descriptions Taken from the 
Account of Muscles and Ligaments —110 
[Galen’s Descriptions of Ligaments and 
Nerves] —110 

[Insertion of Nerves into Muscles] — 111 
[Difference Between Nerves and 
Ligaments] — 111 

[Fleshy vs. Sinewy Muscle Origins] — 111 
[Muscles Without Tendons] — 112 
[Muscles That Do Not Originate from 
Bone] - 112 

[Number of Common Laryngeal Muscles] —112 
[The Pectoralis Minor Muscle] —113 
[The Deltoid Muscle of the Arm and 
Chest] — 113 

[Insertion of the Deltoid Muscle] —114 
[The Latissimus Dorsi Muscle] —114 

[The Iliocostal Muscle of the Thorax] — 115 
[Foramina of the Transverse Septum] —115 
[Orifices of the Stomach] — 116 
[Muscles Moving the Back] —116 
[Vertebral Ligaments] —116 
[Third Wrapping of the Dorsal Medulla] —117 
[Tissues Between the Vertebrae] —11 7 
[Adipose Fat in the Eland] —117 
[Tendon Flexing the Second Bone of the Four 
Fingers] —117 

[Other Flexors of the Fingers and Thumb, and an 
Extensor] —118 

[Extensors of Fingers Not Always Attached to 
Bones] —119 

[A Second Function of the Fleshy Mass Below 
the Little Finger] —119 
[Insertion ofTendons Moving Fingers to the 
Sides] - 120 

[Grooves and Ligaments of the Carpal 
Tunnel] —120 

[Membrane Covering the Transverse Ligament of 
the Wrist] - 120 

[Inner Beginning of the Anterior Muscle Flexing 
the Forearm] —121 

[Muscles Unmentioned by Galen] —121 
[Galen’s Errors in DeAnatomicis 
Administrationibus] —121 

Some False Descriptions Gathered from the Account 
of Veins and Arteries —122 

[The Vena Cava in the Back of the Liver] — 122 
[Branches of the Vena Cava Near the Liver] — 123 
[TheVena Cava Does Not Originate in the 
Liver] -123 


[The Vena Cava and the Great Artery] — 124 
[Galen’s False Partition of the Vena Cava] — 124 
[The Size of the Vena Cava Below the Liver] — 124 
[The Vena Cava and the Heart] — 126 
[The Vena Cava and the Arterial Vein] — 126 
[The Coronary Vein] — 126 
[Other Errors of Galen Regarding Veins, 

Especially in the Cerebrum] — 121 
Accepted Descriptions in the Account of Nerves 
Which Are Not Quite True — 128 

[No Foramen in the Optic Nerve] — 129 
[Nerves Unnoticed by Galen] — 129 
[Origin of the Dorsal Medulla from the 
Cerebrum] —130 

Descriptions of the Parts That Are Contained in the 
Peritoneum, Which Are Not Entirely True — 130 
[Shape and Position of the Stomach] — 131 
[Galen on the Position of the Lower Orifice of 
the Stomach] — 132 

[Whether the Fundus of the Stomach Should Be 
Considered More Fleshy] —132 
[The Pancreas Does Not Close the Lower Orifice 
of the Stomach] —133 

[Fables about Bloodvessels to the Stomach] — 133 
[Location of the Omentum] — 133 
[Position of the Colon] — 134 
[No Vein from the Vena Cava Enters the 
Omentum, Mesentery, or Intestines] —134 
[Galen’s Errors Regarding the Liver] —135 
[No Vein from the Spleen Passes to the Upper 
Orifice of the Stomach] — 135 
[The Search for the Vein from the Spleen] — 136 
[The Left Gastric Vein] — 137 


[Construction of the Kidneys] — 138 
[The Seminal Arteries] —138 
[Distribution of the Seminal Vein and Artery in 
the Testicle] -139 
[The Uterus and the Hymen] —139 
[A Nun’s Cadaver Brought to Pisa] —140 
[A Girl’s Body in the Cemetery at Pisa] —140 
[A Prostitute’s Cadaver Stolen by Students at 
Padua] — 141 

[Post-Mortem Examination of an Eighteen-Year- 
Old Girl in Holland] —141 
[Wrappings of the Fetus] —142 
Several Untrue Descriptions Gathered from the Parts 
Contained in the Thorax —143 

[Orifice of the Pulmonary Vein Compared to 
That of the Great Artery] —144 
[Galen’s Rejection of Statements by the 
Ancients] -144 

[Fibers of Membranes Controlling the Orifice of 
the Vena Cava] —145 
[Small Glands in the Throat Missed by 
Galen] - 145 

False Descriptions among the Parts That Are 
Surrounded by the Skull —145 

[The Cerebrum Is Single at its Base] —146 
[The Dorsal Medulla Is Continuous with the 
Cerebrum] —146 

[Galen’s Errors Regarding the Cerebral 
Ventricles] -141 

[Galen’s Belief in the Reticular Plexus] — 141 
Some Places Where It Is Known That Galen Was Not 
Altogether Sound in Assigning the Functions and 
Uses of the Parts -148 

In His Account of the Bones — 149 

[Where an Epiphysis Does Not Develop] — 149 
[No Epiphyses on the Vertebrae] — 150 
[Motion of the Head Over the First Vertebra] — 150 
[Sylvius as a Professor of Anatomy] —151 
[Galen on Motions of the Head] — 152 
[Self-Contradictions in Galen] —154 
[Lateral Movement of the Hand] — 155 
Several Uses and Functions Not Well Assigned in 

Galen’s Account of the Muscles and Ligaments —156 
[Galen’s Inconsistency on the Function of the 
Eyelid Muscles] -156 
[Galen on the Muscles of the Eye] — 157 
[Colors in the Uveal Tunic] —158 
[Galen on the Temperaments of the Eyes] —158 
[Human Muscles Unknown to Galen] —158 
[Muscles and Actions Misunderstood by 
Galen] - 159 

[The Intercostal Muscles, Unknown by 
Galen] —161 

[Galen’s Inattention to Muscles Moving 
the Back, and Other Muscles] —162 
[Pronation and Supination of the Wrist] —164 
[Muscle Controlling the Neck of the 
Bladder] —165 

[Muscles Moving the Lower Leg] —166 
[The Popliteal Muscle] —169 
Places Collected from the Description of Veins, 

Arteries, and Nerves Where It Is Known That 
Galen Consistently Assigned Incorrect Uses and 
Actions —169 

[Motor vs. Sensory Nerves] —170 

[The Flow of Humors in the Nerves] — 171 


A Description of Some Things That Are Contained in 
the Peritoneum — 171 

[An Alleged Function of the Pancreas] —172 
[How the Upper Orifice of the Stomach Is 
Closed] —172 

[Function of the Spleen] —172 
[The Death of Marcantonio Belloarmto of 
Siena] —173 

[Post-Mortem Examination of Prospero 
Martello] —175 

[Post-Mortem Examination of Seigneur de 
Hallewyn] — 176 
[Sylvius’ Galenism] — 177 
[Ioannes Eck’s Complaint] —177 
[Ioannes Dryander’s Publications] — 178 
[The Quarrel of Cornarius and Fuchs] —179 
[Galen on Vessels Delivering Material to the Left 
Testicle] -179 

From the Description of Parts Located in the Thorax 
and Skull —180 

Some Invalid Anatomical Proofs of Galen Are 
Mentioned — 181 

[Galen on the Origin of Veins] —182 
[Galen on Plants and Seeds] —182 
[Galen on the Vena Cava] — 184 
[Bloodvessels Connected to the Heart] —185 
[Galen on the Right Ventricle of the Heart] —186 
[Not All Veins Are Connected to the Liver] —187 
[The Umbilical Vein] —188 
[The Venous Artery and the Vena Cava] — 188 
[Topics to Be Passed Over Here] -188 
[The Relative Positions of the Left and Right 
Kidneys] -189 


[The Glandular Attendants Do Not Produce 
Semen] - 190 

[Location of Human Breasts, and the Effect of 
Monthly Purgations] — 190 
[Veins Between the Breasts and the Uterus] —191 
How Useful the Annotations of Vesalius Have Been in 
Galenic Anatomy, and How Little They Are to Be 
Needed Hereafter — 192 

[On Annotating Galen] — 193 
[Writings Which I Destroyed] -195 
[Commentaries on Rhazes] —196 
[The Usefulness of Comments on Galen] — 191 
[The Folly of Condensing Others’Writings] —199 
[Preface to an Italian Treatise on Use of the 
China Root Decoction] — 200 
Method of Administering the Water of the China 
Root - 201-4 

Prosopography of Early Modern Persons 
Mentioned in the China Root Letter 
Vesalius’ Index of Words and Subjects 



To the Illustrious and Great 
Duke of Tuscany 


Patron of Studies 

Greetings from 


S ince Jacob Scepper, 2 a young man who in my judge¬ 
ment is outstandingly well versed in medicine and the 
disciplines that relate to it, came here for his studies and I 
often met with him concerning the affairs of our native 
country, I began to question him closely about what doc¬ 
tors were doing in Belgium, and whether anything had 
been published by them to assist and enhance our com¬ 
mon studies, of which we had not yet been informed. He 
brought forth among other things an epistle of my brother 
Andreas, who is extremely devoted to your Illustrious 

1 Vesalius’ younger brother Franciscus was the third child of Andries and Isabel Van 
Wesele. He studied Medicine at the University of Ferrara, from where this letter is 

2 Probably a son of Charles Vs diplomat Cornelius Duplicius De Schepper 
( 1501 - 1555 ). 


Majesty and a great admirer of your virtues for which you are so 
praised to all the world, and he is a keen herald thereof among the 
learned and all his friends. Scepper confirmed that he had written 
out this epistle from the original, and entrusted it to me with many 
names so that he could say it was circulating among the Belgians 
variously written out in the hands of certain people and be thought 
no less worthy to them than to himself, so that it would be set in 
type and become common to all. Since it appeared likewise to many 
people to whom it was shown, I did not hesitate to ask Scepperus to 
make me a copy of my brother’s work to send immediately to Ioannes 
Oporinus, 3 the painstaking and highly educated printer, formerly a 
professor of Greek literature, lest it be badly printed through the neg¬ 
ligence and greed of some inferior printer. I know well how great the 
good feeling of Oporinus is towards my brother and with what work¬ 
manship my brother’s writings come from his press. The books of De 
hutnani corporis fabrica and the Epitome based upon them are no small 
credit to him and to our family, theVesalii, and I wish the Epitome had 
not been spoiled so disgracefully by a certain Englishman (who I think 
lived with my brother for a time). 4 He took what had been written 
with great care succinctly as a list in the Epitome and expanded it with 
excerpts taken from the books of the Fabrica of which it is a sum¬ 
mary. He utterly corrupted what had made it most praiseworthy and 
so roughly and absurdly copied what had been set forth with elegant 
drawing and engraving that he preserved no appearance of Oporinus’ 

3 Ioannes Oporinus (Johann Herbst), 1507—1578, son of the painter Hans Herbst, 
taught Latin at the Basel Latin School and Greek at the University of Basel before 
opening his own press. He had published Vesalius’ Fabrica and its Epitome in 1543. 

4 John Caius (1510—1573) records having lived with Vesalius for eight months in 
Padua. See O’Malley 1964, 101, 105—107. A Galen loyalist, he rejected Vesalius’ 
skepticism of Galen’s accuracy in human anatomy. Caius later enlarged the founda¬ 
tion of his former college at Cambridge, which was renamed Gonville and Caius 
College. Caius is wrongly charged here with plagiarizing Vesalius: the actual plagia¬ 
rist was Thomas Geminus in Compendiosa totius anatomiae delineatio (London, 1545), 
see O’Malley 1964, 88 f., 223. See also n. 197 below. 


majestic edition. It therefore seems to me no injustice if the author 
grieves that his name was not removed from that utterly incompetent 
English edition, to keep anyone from believing that such badly made 
and botched illustrations in the whole series of nerves and vessels 
had ever been produced by him. It is strange that that imitator, when 
plotting against the efforts of others with the itch for writing from 
which he suffered, did not read the epistle placed at the beginning of 
De hmnani corporis fabrica in which my brother wrote that he would 
willingly share the illustrations prepared at his expense with a diligent 
printer rather than have them badly printed and forced into a smaller 
format (which can never be large enough in any case). 

As for the publication of the present epistle (which I should 
have thought should be titled a book had it not been written in the 
form of an epistle, however lengthy and varied, and which is seen to 
have grown unexpectedly beneath his hand into the size of a book), 
because it was not possible to make use of my brother’s advice in that 
I feared it would be published by somebody in an inferior way before 
I could be sure of his opinion because of the intervals of distance 
and the crises that are now troubling Germany: I hope he will not 
disapprove of my effort and diligence, or even be angered because I 
arranged for publication (since someone would do that as well). 

To avoid being deceived in my opinion, I judged that this labor 
should be performed for all students of medicine under the auspices 
of your immortal name and enhanced by its splendor. It is very clear 
to me that your Majesty holds my brother in the same esteem as 
do to a man all great men and lovers of letters. He hears easily and 
often from those with whom he now associates daily regarding what 
is widely circulated concerning the swiftness of your resolve, your 
unique knowledge of military affairs, your amazing swiftness (which 
was always certain) in those matters, and the sacred and never suffi¬ 
ciently praised government of your dominions, which should never 
be equal to your heroic spirit. So it is that among so many great and 
famous princes of Italy none is as often mentioned now by Germans 


and Belgians as Cosimo, Duke of Tuscany. 5 This is not only due to 
the civil and military gifts of your mind, but also because under 
your patronage letters and all the disciplines, which had been failing 
because of the neglect of many princes, not to mention the hostility 
of those who are counselors to them or given to them as advisors, are 
now seen to be nurtured and to grow in leaps and bounds. Indeed, 
we know how the family of doctors (to which you seemed the last 
remaining hope, had you not brought into the world wise, elegant 
and supremely esteemed sons, heirs of your virtues) has always con¬ 
centrated all its energies upon the recruitment from everywhere of 
the most outstanding followers of the disciplines and their generous 
support. It did not concern itself in the past whether doctors were on 
the rise outside Italy and were held by other princes of Italy in the 
ranks of barbarians. 

How much you strive to surpass your ancestors in this type of vir¬ 
tue is proof that the ancient university of Pisa, whose ancient splendor 
you wish with so much zeal and generosity to restore, lacks no effort 
on your part in supporting those who you do not doubt are leaders of 
their disciplines.Therefore it is no surprise that in so few years this uni¬ 
versity has begun such great advances to the great credit of all studies, 
and now shines brightest among the great universities of Italy. 

Although critics are by no means absent who impress upon 
everybody the harshness of the weather at Pisa in that most elegant 
place in the world amid the greatest success in everything they do, 
nevertheless with your benevolence, though there was almost no 
need, an excellent provision was made for aqueducts which alone 
were found lacking, and you left nothing undone that would estab¬ 
lish a pleasant home and market for the Muses there. Here too at 
the urgent advice of Francesco Campana, 6 a man distinguished for 

5 Cosimo I de’ Medici (1519—1574) was Duke of Florence 1537—1574 but did not 
become Grand Duke of Tuscany until 1569. 

6 Private secretary to Duke Cosimo. See O’Malley 1964, 451 n. 54. 

many disciplines and virtues, a chief confidant of your Majesty and no 
less zealous in your praise, Juan Bautista Recasulano is the bishop of 
Cortona. For various reasons, and especially because of his incredible 
humanity and efficiency in conducting business, he is remembered 
with great fondness in the court of the Emperor, ' after he ceased 
to be the eloquent ambassador of your Majesty there. You will there¬ 
fore be thought divinely given to the world for the strengthening and 
recovery of the disciplines. That is what everybody immediately began 
to foresee after your father Joannes, 7 8 easily the most highly praised 
commander in war of all in our memory (as he gave in no small 
measure to fate), when you were still very much a child took you 
from your nurse’s arms and had you thrown headlong from a win¬ 
dow higher than anyone could easily believe (were it not well known 
to everyone in Italy), as your genius was hurrying to the aid of your 
father. That was to determine whether his son, the one he hoped you 
would be, because you were taken up without any harm in his lap and 
in his mantle and were not to be torn apart into pieces, would fall to 
the ground. Warfare would tell the story, but only the greatest kind, as 
is foreseeable from your disposition. 

Moreover, I believe my brother will be highly pleased to under¬ 
take this labor of his, a hazard of judgement, fortified by your authority. 
The proof of that is that I believe he will not reject the labor when 
your intellect is perfectly adapted to all tasks. For in addition to the use 
of new remedies, especially the method of administering the decoction 
of China root (which I see is given to those who are most devoted to 
your glory), and other medicines that are not unpleasant to know and 
are included in this epistle, reasons are added as well by which a devo¬ 
tee of truth can consider that Galen, easily the foremost of professors of 

7 In addition to his service as Bishop of Cortona, Recasulano was ambassador from 
the duke of Florence to Charles V, 1543—1545. 

8 Giovanni de’ Medici or Giovanni dalle Bande Nere, 1498—1526, famed for his 
exploits as a condottiero or mercenary military captain. 

anatomy, did not dissect humans but described other animals differing 
in many places from humans. Among other things, Galen did not pro¬ 
vide true descriptions and uses of the parts; he often assigned functions 
incorrectly, and made many arguments in anatomy that are not alto¬ 
gether valid. One might well believe that all the things thus set forth by 
my brother are supplied as material to those who put their faith only 
in books, and think that Galen committed no anatomical errors what¬ 
ever or any other mistakes, who have been stitching together writings 
for about three years now (unless they had started even before the pub¬ 
lication of my brother’s book). They refute in order everything he now 
investigates, one by one, as if they fell under common topics. They are 
occupied not only in praising Galen but in writing down calumnies or 
criticisms occasioned by a newly discovered truth. 

By your generosity in the advance of learning, concerning which 
I have more than once heard my brother and many others taking 
pride, it has quickly been achieved that all these discoveries have been 
demonstrated to students at your university in Pisa by his dissections 
of bodies; and you yourself are aware how those who know the most 
in the presence of bodies, and the doctors and philosophers best pre¬ 
pared to correct Galen, have had to resort to my brother’s opinion. 

Indeed, some hope should dawn upon scholars that my 
brother will at some time return to your university and perform 
dissections of bodies for the profession of medicine. I should like 
to take refuge there as if to a free field which you provide for argu¬ 
ments about the disciplines — if only at last some will put them¬ 
selves forward out of many (a number of whom have shamefully 
abandoned the enterprise), so that they may return without dissent 
from my brother’s dissections just as I saw certain physicians come 
wholeheartedly into my brother’s way of thinking when I once spent 
several months in Padua and was present when he was teaching 
anatomy to a very large class. Yet I too now, who was repeatedly put 
to the study of law by my parents contrary to my preference, which 
was inclined to medicine and always recoiled from the law, and by 


the many travels in which I gained nothing but a skill in various 
languages, being now for a long time dedicated I promise that I 
will pay attention to the diligent study of medicine, and in every way 
I will see to it that so far as I am ableVesalius will not be perceived as 
having been called away from his studies into the imperial household. 
I shall endeavor at some time to perform his role in dissections and for 
his sake I shall undertake to show to others the true facts he sets forth 
in the present work, and quickly and easily repel the sharp pens with 
which Sylvius (as if my brother needed to be deterred from his fine 
undertaking and hence from the truth) threatens him. 

Since my brother now has little time at his disposal to refute the 
trifles of those who vainly strive to defend Galen in a matter that is 
self-evident and contrary to the senses, it is perhaps in no small way 
proper to my studies to fulfill my brother’s duty and set forth much 
more copiously things that will stir the anger of those people in no 
half measure (since they disparage trust in reason and their eyes). 

In the mean time I wish earnestly to ask your illustrious Majesty 
that he forgive this audacity of mine that I desire to act as advocate so 
freely and shamelessly on behalf of so many paradoxes and doctrines 
still quite alien to the ordinary study of medicine, and ascribe my 
brother and myself with all reverence to your Majesty in the number 
of your most dedicated servants. 

At Ferrara, the third day of the ides of August in the year after 
Christ’s birth 1546. 9 

9 Misprinted M.D.LXVI, 1566. 

To the Most Learned 



Chief Physician at Mechlin 


have at last come to Ratisbon 
together with the Venetian ambas¬ 
sador Bernardo Navagero, * 11 a 
special credit to his country not 
only for his famous knowledge of 
the disciplines but for many other 
reasons as well. Besides the presence there of close friends, 
the pile of letters accumulated in my absence diverted 

10 Born in Mechlin in 1496, Roelants entered school in Louvain and became a licen¬ 
tiate in medicine; he established a practice in Mechlin and served in the court of the 
Netherlands regent Margaret of Austria. He succeeded his father Cornelius as city 
physician of Mechlin in 1525, a post he held until his death in 1558. See O’Malley 
1964, 454 n. 146. 

11 Bernardo Navagero (1507—1565) belonged to a patrician family in Venice and 
attended the University of Padua. Following his ambassadorship to the court of 
Charles V 1543—46, he served as ambassador to Suleiman the Magnificent 1550—52 
and to pope Paul IV 1555—58. Named cardinal by pope Pius IV in 1561, he was 
bishop ofVerona from 1562 until his death. 


my mind from the weariness that I had to endure at the Emperor’s 
behest in the difficult and grave medical crisis at Nymwegen. 12 It is 
amazing how much pleasure a quantity of letters from various places 
can bring; it is now a greater pleasure the larger the number there are 
to be read through together. I was delighted to read among the others 
two letters which I found written by you along with letters of your 
son, 13 a young man with the best prospects in my craft; you may read¬ 
ily imagine how delighted I was from the fact that they are the most 
trustworthy proof of your affection toward me, and they always have 
something to say about our activities and common enthusiasms. For 
this reason they deserve my greatest anticipation. Besides that, I was 
informed at length by your son’s letters what the great defenders of 
ancient medicine (in my view) were up to in Paris and what was the 
success of their studies there. 

While I postponed a reply to your letters because I was busy 
and needed to write my parents about private business, your letter 
was delivered to me asking me to write out the procedure by which 
a decoction of what is called the China root was administered to the 
Emperor and many in our court. 

Occasion for writing about the China root 

You also asked what my opinion is about that root, how success¬ 
fully I use it, and with what recovery from adverse health. My 
friend Antonio Zuccha, 14 whom you praise in your letter for his 

12 Roman Noveomagus, mod. Nymwegen or Nijmegen. For the stay at Nymwegen 
to attend the illness of Navagero early in 1546, see Roth 1892, 207, and O’Malley 

13 Martin Roelants, 1521—1598. 

14 Antonio Zuccha or Zucca is mentioned in the 1543 Fabrica for his interest in the 
larynx: “... a young man of outstanding talent, Antonio Succha, the rare and great 
hope of our common city Brussels, and indeed of all Belgium, on account of his 
singular knowledge of medicine and mathematics” (Bk. II ch. 22). 


uncommon friendliness and well-known learning, is privately ask¬ 
ing me the same questions. It is also remarkable how earnestly and 
carefully the German physicians of this region and functionaries in 
the households of their nobility are inquiring about the prepara¬ 
tion of this decoction. They will not cease being a nuisance or put a 
stop to their prying and importunity until they learn the procedure 
by which they believe we administer that decoction. Besides certain 
things I will pass over in silence, they were so keen to gain this infor¬ 
mation that they have seen fit to extol the potency of this decoction 
to their princes so that the princes themselves have not hesitated to 
press home their entreaty on their doctors’ behalf in the Emperor’s 
presence in the hope that the entire method of administering the 
decoction would be explained by us to them. 

With what success many have used the China 

So great was the fame and reputation conferred upon the medica¬ 
tion in a short time by the prestige of the Emperor, who took the 
China decoction more on his own initiative than on the advice of 
Dr. Cornelius 15 (whose services he principally employs since the 
departure of Dr. Cavalius). 1,1 While I was still visiting the sick under 
Venetian instructors and the principal doctors practicing there, this 
root was favored there with the greatest expectations and highest 
praises. But it was put to use in one case after another with little suc¬ 
cess. This was the result not so much of a fault in the medication or 
inexperience in its administration as the fact that it then began to be 

15 Cornelis van Baersdorp (ca. 1485—1565) of Bruges, second-ranking of the Emperor’s 
physicians after Narciso Vertunno. See O’Malley 1958, 473 if., and 1964,194 f. 

16 On Dr. Caballus, “a physician of no particular merit [who] possessed the knack of 
gaining and holding the emperor’s confidence,” see O’Malley 1958, 478 ff, and van 
Male 1843,14—15,22—23. Caballus did not, in fact, leave the service of the Emperor. 
He is reported as still in Charles’ medical retinue in 1551. 


given to patients who were otherwise near death and in whom no 
cure could be expected by a doctor. 

The first patient to whom I saw a decoction of the China 
administered, had it sent from Antwerp together with an empiric 
who said he knew its use well and had administered it successfully 
in Portugal. The patient was suffering no symptom of the Gallic 
disease 17 that was not severe, and was extremely wasted as if bearing 
death in his jaws. As soon as a sweat appeared to be brought on by 
virtue of the China, urinations were moved at the same time and 
he took less nourishment than usual; he immediately expired. When 
his internal organs were examined at the request of his parents and 
friends, they were in such a state that no reason could be imagined to 
explain how life was prolonged for such a time in a person. Another 
patient who was being given the China decoction about the same 
time was seen to have the Gallic disease without any damage to the 
skin but with extreme thinning or emaciation of the body; he had 
developed significant stones in his left kidney. After he had used the 
decoction for about ten days the doctors recommended that it be 
diluted because of the extraordinary power they believed it had to 
liquefy and produce urination and sweating; after a few days he died 
with extreme pain in the kidneys. 

After use of the China had been ridiculed and made light of by 
everyone more on account of serious harm to the sick than because 
of its virtues, and was virtually unmentioned, another physician came 
from Antwerp solemnly declaring that the China was a unique and 
sacred medicine and saying that there was no illness however deplorable 

17 Syphilis, called the “Gallic Disease” because Charles VIII s French mercenaries 
spread the infection following their two-and-one-half-month occupation of Naples 
in 1495. The French called it “the Neapolitan sickness”; the Italians called it “the 
French sickness.” See Claude Quetel, The History of Syphilis, pp. 11 ff.The modern 
name derives from Girolamo Fracastoro s poem Syphilis (1531), which popularized 
the doctrine of “seeds” of disease. See J. Arrizabalaga, J. Henderson, and R. French, 
The Great Pox. The French Disease in Renaissance Europe (Yale, 1997), pp. 244 ff. 


for which it could not bring relief. The nobility trusted him so much 
(since he could also be credited with some erudition) that the China 
was given to the bishop ofVenice, who lay ill with a wasting disease 
and unknown maladies. But before he had fairly begun to use it, the 
man, worthy of every praise, passed to his ancestors. So it was that so 
long as I was in Italy the China decoction had been fully rejected; nor 
did I, following my teachers, make much of it. 

I hear that at about the same time a fellow student in Burgundy 
had employed a China decoction prepared with wine and great prom¬ 
ises. But such was its success that since then the name of the China has 
scarcely been heard. A year ago, however, the most famous man in the 
world, Jean-Baptiste Gastaldo, 18 was bedridden much of the winter in 
agony of a nervous type below the loins and suffered a kind of paraly¬ 
sis together with a weakness of the stomach and appeared restored to 
health before the beginning of spring. After he had begun to be up 
and about, at the persuasion of some friends he used China decoction 
with good success.There was likewise the Spanish nobleman who you 
knew was brought from Mechlin 1 ' 1 to Brussels: he made the China 
more praised than many other treatments. Also at that time four or 
five patients who had the Gallic disease urged the doctors to treat 
them also with the China decoction; in some of them we saw a very 
praiseworthy outcome. In others, though, who were more gravely 

18 Count Palatine Giovanni Battista Gastaldo was one of the Emperor’s two 
Quartermasters General in the Imperial army, with Stefano Colonna in the 
Smalcalde War of 1540. “Gastaldo is esteemed a very practical man, and one pos¬ 
sessed of correct judgement. His naturally good understanding has been improved 
by a great deal of experience ... He discourses well and eloquently about the 
things he has seen; which are many, being a man of fifty years old. Yet his speech 
sometimes reveals too freely what is on his mind, seeing that his long services to 
the Emperor have been but inadequately requited.” — Address to the Doge and 
Senate ofVenice by Bernardo Navagero on his return from Germany in July 1546. 
Bradford 1850, 451 f. 

19 Mechlin was the city in which Roelants served as City Physician. The unnamed 
Spanish nobleman may have been Ludovicus Sanches (see n. 25 below), though his 
treatment was apparently not entirely successful. 

affected with the disease, we observed a much lesser outcome than we 
should have hoped from a decoction of guaiac wood. 2 " 

You will likewise be aware that after setting aside the China the 
Emperor took a decoction of guaiac for his gout 21 and poor physi¬ 
cal condition. There is no end of praise for novel remedies in certain 
quarters; several nobles of Spain were declaring to the Emperor and 
many other leading men that nothing is more perfect to prescribe 
for all diseases than this China and emphasized that guaiac wood is 
totally rejected in Spain and some parts of Italy, citing letters from 
their friends as well as various others who swore to the same view. A 
certain passion to take the China decoction came over the Emperor; 
he was more easily drawn to it because the China was so much 
recommended: the duration of treatment was brief, the dietary reg¬ 
imen was much easier than with the guaiac decoction, and it was 
prescribed with less commitment to rules (so to speak). So it was 
accomplished that people who are not present, knowing that the 
greatest ruler in the world used the China, have magnificent feelings 
and judgments about this remedy; they think they will be missing 
many things if they too do not also learn the system of administering 
this decoction. However, an argument for recommending the China 
would be of little effect coming from the Emperor, since he had used 
the China for only fifteen days, with an inconsistent diet, and with 
a frequently altered manner of dosage. Though he did not have dif¬ 
ficulty breathing, nor for periods of time agonies of gout, the joint 
by which the left humerus is attached to the scapula for the past year 
felt somewhat impeded in the motion by which the arm is raised by 
the power of the deltoid muscle but now feels quite free. The same 

20 An oil or gum distilled from guaiac wood (Guaiacum officinale L.). introduced to 
Spain from the West Indies in 1508 and made popular in 1519 by Ulrich von 
Hutten, guaiac was used as a treatment for syphilis. 

21 Articularis morbus could be any form of arthritis but will here be translated as gout. 
On Charles Vs attacks of gout, see Tyler 1956, 71; O’Malley 1958, 471 If.; van Male 
1843 passim. 

problem was resolved in the left leg: during the same period, next to 
the ankle bones and the joint of the talus with the tibia, motion was 
quite impeded and seemed in general to mar his elegant form. In 
addition, when the Emperor was in the mood he had when he felt 
well, he was seen to discontinue his decoction under the pressure of 
urgent business, and in autumn he more or less decided to resume 
it with greater exactitude. At present he possesses the health that he 
especially enjoys when in the army and that all good people should 
wish with suppliant prayers that he have continually for the sake of 
the whole world.You know how well he thrives then, in the exercise 
of his full skills and supreme occupations. Consider also that after he 
takes the China he usually arises earlier than usual, sometimes for 
hunting before breakfast or riding by horseback to the most pleas¬ 
ant places that lie hereabouts, and taking lunch at not such a bad 
hour, for example after noon (as he often does), so that now a longer 
interval passes between his bath and a heavy lunch, which is a mira¬ 
cle to many, and the very light supper he is accustomed to take. But 
precisely these reasons reveal at least a good concoction if nothing 
else, that tends for various reasons to be spoiled from time to time. 
But no doubt you have heard more than once from the Imperial 
physicians, with whom you were previously associated, what the 
Emperor’s style of life is and how much attention he pays to medi¬ 
cal instructions. I am therefore not surprised that Dr. Cornelius was 
severely vexed with those who were responsible for the ways in which 
his diet 22 was to be established as a precaution against the volume of 
excremental fluids; by this diligence provision was to be made for his 
inner organs so they would perform their task faultlessly. Finally, if 
any excess humor should be accumulated, how it should be expelled 
by the attending portion of their art before descending into his chest 
or joints. They also looked after ways in which strength should be 


On Charles Vs unhealthy diet, see Brandi 1939, 560,622;Tyler 1956, 271; O’Malley 
1958, passim. 


won over for the joints lest they take on an onset or influx of humors 
or transform otherwise benign nourishment that has been delivered 
to them into malign juices which the joints afterwards do not expel. 
They also mutter quietly among certain great men about how by 
diverting a humor ulcers can be created in some places by means 
of caustic medications, and they promise perpetual immunity from 
difficulty in breathing and the most certain illness of the joints — but 
they also publish these matters in pamphlets written to the Emperor 
at the pretext of some prince, just as if such matters were unknown 
to those whom the Emperor has put in charge of his health, and he 
were subjecting himself to medicine to be so unhappily troubled. It 
is a good thing that as long as he was still present Dr. Cavalius would 
urge the Emperor to be wary of bringing in such smatterers who 
would create a danger as great as precepts of such medicine might 
be useful. He would explain how much easier it is to make elegant 
speeches or write books about such things in the schools than to put 
them into actual daily practice on princes (who also claim power 
in medicine for themselves); this is especially true for gout, which 
sometimes severely infests all joints in the body. However, this topic 
leads in a direction other than the China decoction. You can easily 
guess how much praise for this decoction can be derived from the 
health of the Emperor. The celebrated Lord de Bossu 2 ' may well be 
consulted about this: it is seen that in taking this decoction he closely 
imitated a certain prescription 24 sent to the Emperor (from which 
a sort of formula for administration to my patients has been taken). 
It should be gently employed only for the drying of the body, and 
for strength, namely for gout and weakness of a neurological kind, 

23 Jean de Henin-Lietard, (aka le Grand, 1499—1562): childhood friend and Grand 
Equerry of Emperor Charles V, who made him Count de Boussu in 1555. Scion 
of an aristocratic family in Hainaut, Belgium; his castle was visited by Charles V in 
1545 and 1554. 

24 A marginal note adds “We have placed this text at the end of the Epistle.” 


though the patient may have suffered pain in the joints for months 
before use of the decoction or immediately before. The tremor of 
the hands seems to have been familiar to the Emperor for many 
years, about the same after using the decoction as before. When Lord 
Ludwig Sanches, the ruler of Sicily , 23 a man outstanding not only for 
his many rare natural gifts but also for a rare knowledge of discip¬ 
lines and facts that all may observe, clearly experienced weakness of 
the stomach resulting from cold and moisture, a constriction of the 
veins weaving through the liver, obstruction of the bile ducts, and 
a phlegmy deflux from the head (as he has a quite uneven bodily 
constitution), he read through praises of the China decoction and 
being that way encouraged by friends, wished to have it prescribed 
to him. But in his case the method of coction had been quite altered 
(because water seemed to harm his stomach) and a drying diet was 
begun combined with the use of opportune purgations, though I 
should have wished a man worthy of the most perfect health to attain 
a more desired end. Nevertheless one of his close friends, to whom 
he wished the decoction to be demonstrated at the time, appeared 
to be quite well cured of the Gallic disease. But before administra¬ 
tion of the decoction I had first employed sometimes venesection, 
sometimes a boiled-down poultice of Mesue 26 altered as usual with a 
quantity of hellebore 27 and a measure of milk whey, as I had also used 
other appropriate purgations in the employment of a decoction and 
a light and quite drying diet as we usually approve in the taking of a 
decoction of guaiac. 

I achieved the same success in a number of other cases; but 
they wished to use the China decoction more on the advice of their 
friends than on my recommendation, and they did not suffer from 

25 Ludovicus Sanches (d. 1549), a Spanish nobleman, was protonotary or chief legal 
officer of the king of Sicily. 

26 Ioannes Mesue the younger (d. 1015), author of an Opera medicinalia. 

27 Any of fifty species of the genus Helleborus, most likely the species collectively 
known as “black hellebore” used in treating gout and other diseases. 

bone growths, tumors, or malign ulcers, for which I am very certain 
the China decoction is far worse than a decoction of guaiac wood. 
Moreover, everything turns out better with the China decoction the 
more closely we imitate the procedure that we employ in the presen¬ 
tation of the guaiac wood, in a manner largely unchanged from the 
way the China decoction first began to be administered, unless per¬ 
haps someone should appear who is filled with bitter bile, in whom 
the constitution of the body and the disease are systematically con¬ 
sidered. I have said these things so you will understand the extent to 
which I can respond to your request, in which you wish to have the 
method prescribed by which we administer the China decoction. I 
am not ashamed to admit my ignorance to you, particularly with this 
medicine, because not so long ago I dared to dispense it without a 
system, given as if by hand but led by bare trial and error. Until now 
I could not even be certain of the root’s name, as the root itself is 
known in other ways. 

Description of the China root 

By some it is called Chyna, by others Chynna and by others Cyna,just 
as you only write Echina and it is called simply Achyna, as if an island 
or a place in India or in the recently discovered world 28 had supplied 
its name. It is imported by the people who bring in pepper, cloves, 
ginger, and our cinnamon: Portuguese and people sailing under the 
patronage of our Emperor. Those people say it is gathered around the 
shores of the sea, and as is likely in marshy areas of the sea, just as we 
observe roots of various species of reed and similar stalks growing. In 
fact if we rightly consider such roots, after they have been pulled from 
the earth for some reason or another by sailors or fishermen, or for 
any other reason are split into various fragments of uneven size, then 

28 That is, the New World. 


rolled in seawater for a long time and finally rest on sandy beaches, 
their appearance is very close to that of our China. 

I do not know what it could better be compared to than roots 19 
of the stalks just mentioned which present themselves to view in this 
way by chance on the shores of the sea or some rivers. Those are per¬ 
haps darker, whereas the China is slightly reddish like common bitter 
root or what we call galanga . 29 Indeed, what is more like the China 
than this acorns 30 after it has rotted and taken on a dull flavor if you 
take away its size and hardness? The China is notable for its large, 
rough, and uneven pieces, and is a little more woody though also 
significantly spongy and like the previously mentioned roots when it 
grows it is definitely succulent like the kind shipped to us, and soon 
shows itself very dry and often infested with worms. 

When this happens you may find merchants who to pretend 
that rot and worms are not present wrap the China in the ordinary 
Armenian bolus 31 of the pharmacies in the same way that we know 
ginger is covered in the glutinous earth that is reddish and offered 
for sale in shops, especially in Antwerp. I have questioned our mutual 
friend Gerardus 32 (as he is especially expert on stems as he is on every¬ 
thing else) whether in his legation to Turkey he had learned anything 
definite on the subject of the China. However, I was unable to learn 
anything else from him but the fact that the China is imported to 
Constantinople also and was employed by a certain Jew with less suc¬ 
cess than the hope and expectation of the sick. From merchants I was 
able to learn only that the China is found near seashores and that the 

29 Or galangal, a rhizome of plants belonging to the ginger family. Its medicinal uses 
originated from Indonesia. Hildegard of Bingen (1098—1179) used it in various 
medicinal formulas. 

30 Acorns calamus or sweet flag, a grasslike evergreen plant, was cultivated in Asia for its 
medicinal properties. 

31 Armenian bole (bolus armenus, bole armeniac) is a usually red earthy clay native to 
Armenia. It was used as an astringent against diarrhea, dysentery, and hemmorhage. 

32 Identified in Vesalius’ Index with surname Vueldwick. 



natives use it for scabies just as we use rumex or lapatium . 33 But there 
is no lack of people who to make the China more marketable sol¬ 
emnly assert that every kind of illness is kept from the natives by the 
China decoction. We single out the China for our purposes, just as we 
do rhubarb and other roots, because it is outstanding in weight and 
as far as possible in that very dry root, succulent and less beset with 
worms or rot, and more resistant to other damage from putrefac¬ 
tion which it was able to keep out of its spongy, damp substance while 
drying. We should be quite careful in selecting these pieces, particu¬ 
larly the smooth and thin ones, from the woody and coarse pieces and 
those that split open at intervals; though the first and second qualities, 
as we call them, are still unclear to me; these show how great a pre¬ 
eminence the medicine possesses, by which many recommend it to 
the public. For since we distinguish its strength chiefly from its taste, 
why will we say it has a tasteless and quite sluggish flavor? For when¬ 
ever you chew the China, which is otherwise dry and woody in con¬ 
sistency, and grind it with your teeth, you will be able to confirm that 
it has no flavor; still less (so far as is in its nature but not that of drugs 
close to it) does it present to a person tasting or otherwise handling it 
any odor or anything oily, which others contend they have observed 
in it. It deserves promotion or praise in a much different way from 
guaiac wood or the medications that are indigenous and familiar to us; 
we would be able to commend those with many praises for the uses 
for which the China is considered a sacred refuge. No one is unaware 
how much hope would be placed in the present circumstance upon 
the lesser and greater roots of centaury, upon rhapontic, bell of hele- 
rius or enula, aristolochia, gentian, galingale, cinquefoil, sorrel, and 
upon roots of such plants together with caper root (if one wants to 
adopt something astringent like that), wormwood, hyssop, calamint, 
pennyroyal, chamaedrys, juniper wood, our spikenard, decoctions of 

33 Rumex or lapatium, the genus of docks and sorrels, was thought to have astringent 
and purgative qualities. 


the inner bark of ashwood, and other simples of that kind, since we 
would not be as irrational as the sick themselves to marvel so much 
at those exotics and put them to use no matter how much they are 
at odds with reason and the method of our art. I am unable to com¬ 
prehend how something that many have long since credited to the 
China comes to be ascribed to it, and with what new impulse it now 
begins to be credited with new powers as its fame grows. Presumably 
it is hot, possessing the faculty of opening; it notably brings on urina¬ 
tion and sweating; it is found to be a consumer and dryer of redun¬ 
dant and harmful substances and any number of different fluids and 
is thus a cleanser of the blood; it possesses the virtue of assuaging and 
cleansing; it keeps the belly now loose and now, when it chiefly brings 
on urines and sweats, tight. It is a remedy for a stomach beset with 
phlegm; it drives off diseases of the liver and spleen in no small way; 
it is an effective protection for those whom the stone torments and 
breaks it up. It drives off gout, especially benefits elephantiacs, cures 
skin diseases, and is no ordinary help for fistulas and malign and oth¬ 
erwise incurable ulcers. It divinely heals the Gallic disease for both 
recently and earlier infected patients, heals the ulcers caused by it, and 
repairs their scars. It crushes agonies in any limb, dissolves tumors, and 
aids any that are about to suppurate by heating, then opening, clean¬ 
ing, and producing a scar. It brings health to corruptions and abscesses 
in the bones, relaxes convulsed and contracted sinews, dries those that 
are slackened and softened, and heats sinews that have been numbed 
by the Gallic disease; it fattens sinews troubled by wasting therefrom. 
It induces a pleasing odor to bodies that are festering and corpse-like, 
removes bad breath, and protects those who have trouble breathing. It 
scatters lengthy anginas, drives off injuries to the brain resulting from 
the Gallic disease, and halts every kind of fluxion with an uncommon 
benefit. Finally, the China is esteemed for the same virtues as guaiac. 
In fact, it is preferred to guaiac for many more faculties, even those 
that contradict each other, since the previously mentioned dull taste 
occurs in the China without any indication of astringency. 



However much you boil it in plain water, you will not give the 
water a different flavor than you will notice comes from barley not 
cleaned of its husk and the smallest portion of a sweet root; the China 
decoction is slightly red, very much like a tawny wine or wine that 
has taken on a red color from long storage in ajar. So from the point 
of view of manifest qualities, from a decoction of this root there is less 
reason to hope for stimulation of sweat and urine and the virtues for 
which the China is today praised, than could be expected from bar¬ 
ley water. In fact, to conjecture from this evidence, when the China 
is to be used on the sick a decoction thereof should preferably be 
offered to those whom we see involved with the slow fevers, acrid 
humors, and altogether bilious condition of the Gallic sickness. Only 
with these patients, so far as concerns the method of our craft, have I 
known any genuine success from the use of the China decoction. I am 
also convinced that the China was first praised for this use. 

Although, my Joachim, the various and more or less diametrically 
scattered virtues of the China arise from this success, and while those 
who use its decoction (without neglecting the skillful use of medica¬ 
tions that necessarily accompany its administration and an opportune 
dietary system) sometimes meet with the desired end, our gadfly which 
we too often avoid should not be absent: I am talking about the recon¬ 
dite and occult faculty which we say is specific and essential, by which 
we establish the fourth order of medicines. This refuge is so broad that 
it embraces everything; we observe nothing hidden and unknown that 
we do not refer to this category. What exists in the present that cannot 
be ascribed to this wide field of the China? And not only to the China 
but to any spongy and rotten wood? Consequently our reason should 
no longer consider only the powers of the China, since it easily allows 
us to take refuge in the declaration that the China moves urines and 
sweats and removes faulty humors through sweat and hidden respiration, 
and we know that many purgatives drive out a select, particular humor. 
On these grounds there will be none of the powers that anyone can 
claim is falsely ascribed to the China by those who have instituted it. 


Method of preparing the China decoction 

At some point it will be time to relate the method of preparing the 
China decoction and the technique ofproviding it that was largely pre¬ 
sented to me more or less by hand in an Italian text. I will accomplish 
this more quickly and with less trouble, the more it can be described 
by a man long learned in the practices of our art and the greatest help 
of his fellow citizens. As soon as we have employed a purgation of the 
bowels, emptying of the first veins and then, if the occasion demands, 
venesection and the appropriate digestion of redundant humors, and 
finally the actual purgation according to the accustomed method for 
the sickness at hand, we present a China (as I previously explained) 
that is more dense and less affected by worms or decay, and as far 
as I can judge fresher in appearance and less dry. A twelfth of this is 
split transversely with a sharp knife into the thinnest possible discs or 
pieces just as if one were to separate coins lying on top of each other 
in a cylindrical figure or divide up an orange or a radish on a table 
transversely into pieces.The pieces are thrown into a leaded clay vase 
or what we also call a vitreous jar that can contain more or less six¬ 
teen pounds of water for convenience in cooking; it should not have 
too large an opening, and it should have a lid that fits. Twelve pounds 
of water are then poured over the pieces; it should be spring water 
or be otherwise close to that, and be thought on the basis of good 
and special evidence to be excellent and highly praised. In observing 
a water source, aqueducts claim no small priority because water 
should not flow a great distance through lead pipes. For the China 
to be better steeped in water for twenty-four hours, the jar should 
be kept over hot but not burning embers for that period of time. The 
decoction should then be kept in a slow, continuous fire that is not 
smoky until a third has evaporated. This point is best reached at night 
or at least in the evening of the day before the decoction will be used. 
Soon after cooking the water should be strained through a linen cloth 
and poured into another jar; or it should be left unstrained in the jar 



and only so much as the patient will consume at the time should be 
strained from the jar. However you do this, whenever the pieces of 
the China are free from the water in which they were cooked and 
slightly dried on the strainer or another cloth, they should be put 
away somewhere for the use you will hear they have in an apparatus 
of second decoction. For this purpose the jar into which you have 
drained the strained water or the pot in which it was cooked should 
be placed for a while on warm embers or wrapped in towels or cloths 
and removed a little from the fire to keep it from cooling for a while 
until there will be a use for the decoction throughout the day. It serves 
for only one day, and the decoction should be produced fresh daily 
as long as it is taken. Those who promote the China fear that if it is 
kept too long it becomes acid and is somehow spoiled more quickly 
than a decoction of barley, forgetting how much heat and how many 
aromatic powers they otherwise attribute to the China when they say 
so much about it. 

Quantity of the first China decoction to be administered, 
and the time to give it 


Eight ounces 34 of this decoction or a little more should be given in 
the morning so it can be delivered when hot, and the same amount 
four hours before supper, during which, as at the mid-day meal, the 
decoction should be served warm in place of a beverage. I take the 
time of dosage, as with the decoction of guaiac, from the natural 
intervals of the day, so that the right spaces will be established from 
the twenty-four hours. So that a hot decoction be served at the 
fourth hour in the morning, lunch should be at the eighth hour; it 
should be served again hot at the fourth hour in the afternoon, 
and dinner at the eighth hour. In other words, so that four hours 

34 Lat. unciae; an uncia is the twelfth part of a unit. 


intervene between taking the hot decoction given in the morning 
and lunch; and between lunch and taking the hot decoction after 
noon, eight hours, and between this dosage and supper, four hours. 
Between supper and the drink presented in the morning, eight 
hours also pass. We might instead in certain regimens for a patient 
decide to extend the final interval and wish the lunch to be more 
coterminous with supper, giving the decoction an hour or two later 
in the morning. 

How a sweat should be induced 

When patients take the decoction in the morning, they should lie in 
bed covered just as if they wished to induce a sweat. After it comes on 
as planned they should be wiped off everywhere with warm cloths 
without uncovering the body, and when the linens are pulled off if 
necessary a clean and well-dried nightgown should be put on. To 
avoid having to pull the linens away from the sweat or move the 
patient to a cold part of the bed, we fold a large bed linen together 
four or five deep into the same narrow space so they lie beneath the 
patient’s arms and legs lengthwise and wrap his chest. We then put 
another folded linen beneath the head and neck; its two ends cover 
the whole chest and a part of the abdomen, and the head is also pro¬ 
tected according to plan. Because these linens make no small contri¬ 
bution to raising a sweat, when wet they are so capable of removing 
a sweat that after a session of sweating the patient can rest for a time 
in dry linens that are still warm from being laid upon and then get 
out of bed and having tried the means that effect removal of any kind 
of wastes, can take his midday meal. When a decoction of the China 
is administered before supper, the patient should take to his bed, 
and the same procedures we said should be performed before lunch 
should be followed. 

You know without my saying so from administering decoction 
of guaiac and from the initial abundance of serous humor that patients 


are eager for more lengthy and copious treatments during the first 
days than in those that follow. But decoction of the China is many 
times worse than guaiac in bringing out sweat and urine. 

There have been some for whom decoction of the China 
removes no sweat at all, just as we try in vain to bring on a sweat with 
a decoction of barley when the humors are thick or the skin dense. 
Similarly it is known that even guaiac has sometimes failed to pro¬ 
voke a sweat for the same reason except after several days. In admin¬ 
istration of the decoction before supper, I do not know why some 
doctors reduce the dosage when using the China or Guaiac, and 
why before supper it is administered differently than several hours 
after supper before the patient sleeps, as if they thought he would 
snore all night in a sweat. That is why the Emperor also recently 
exchanged this regimen, which was prescribed throughout the time 
when guaiac was used, for some method that he believed to be the 
custom of the empirics. For while in the beginning he also took his 
decoction of the China after supper, following the example of Lord 
de Bossu and certain others, he now passes over this method and 
drinks what he used to take before bedtime several hours before sup¬ 
per with better results. 

Those who prescribe use of the China have declared that 
a measure of a cyathus 35 of the decoction be administered in the 
morning and after noon; in place of this the Emperor took more 
or less ten ounces. But since this decoction of the first and second 
quality is scarcely better than a decoction of barley, I have guessed 
that it harms the stomachs of some patients, and have taken care to 
boil in an ounce of the China with six pounds of water until two 
pounds evaporate so that when this is done five or six ounces of the 
decoction sometimes are enough. Sometimes I have prescribed that 

35 The cyathus, originally a Greek wine-ladle and an Attic measure of about 1/12 pint, 
was later a type of wine-cup which was a standard unit of medicinal measurement 
in the 16th century. 


two or three ounces of the china be boiled with twelve pounds of 
water to see whether a decoction from this process acquires more 
strength and power; for I think that such a small quantity of weak 
China root is boiled in such a large amount of water because it is 
sold by weight to many crowned heads. Although others have made 
this comparison when I recommended they make the same test with 
their patients, they disapproved this system of variation because I 
was trying to force a medication accomplishing so much with a lit¬ 
tle known power to a different end than others testified their expe¬ 
rience recommended. But the pattern of variation has not so far 
seemed a hindrance to the method of guaiac treatment, as I am com¬ 
pelled to say it is with the China. For the same reason the air about 
which users of the China debate should be mild. The reasoning is 
taken from those to whom guaiac applies; those who first began to 
prescribe the China do not recommend the complete interval in 
a room that is closed and lacking in free air to breathe or without 
ventilation. In fact they allow patients to go out after the seventh or 
eighth day provided they walk moderately dressed and out of the 
wind and it does not disagree with their bowels. But I have so far 
given the China to no one who has not stayed in the same room or 
at least not avoided fresh air. This is not to say that so much power 
lies in thinning the China that I think because of the open pores of 
the skin air seriously disadvantages those using the China. Rather, I 
believe the tepid air and plenty of clothing keep the body readier to 
sweat and aid the weak power of the China. It is also for this reason 
that not so much calculation needs to be made of the time of year 
when it is better to take a decoction of the China as is needed in 
the use of guaiac; that is because we need not so much fear a distur¬ 
bance of the air after drinking the China decoction, when the skin 
is somewhat rarefied. 

Moist food is recommended first, being suited to acidity of the 
humors and great dryness; this includes young poultry or capons 
boiled and fish if any good ones are available and the patient has a 




strong appetite for them. They have determined that bread not be 
reheated or, as we say, twice cooked, but otherwise food should be 
cooked in the common way but without the seasoning of salt, just as 
they want salt left out in boiling meat and in every procedure. They 
prohibit ingredients containing vinegar and acids, the frequent use 
of sauces, and herb flavorings. They have also made their prohibition 
absolute for the first fourteen days and rule out for the remaining 
time all meats, which we approve in a drying diet. They permit sea¬ 
soned items that we have in our pharmacies as preservatives, but only 
ones that sweeten; to these they add the flesh or juice of quinces pre¬ 
pared without the admixture of any aromatic. In a word, everything 
they recommend is altogether alien to a drying diet except for honey, 
which is the only such thing they approve of eating. I think they 
recommend honey prepared in the way it is said to be cooked by 
the Spanish, familiar to the Emperor at supper in winter, and which 
you know is quite beneficial against difficult breathing. The weight 
of bread, meats, or other food is not precisely determined except that 
they prefer a light diet, and the more meticulously it is established 
the happier the outcome they say can be expected from the China, 
adding with the greatest truth that no less a reward is conferred by 
a diet of this kind than is gained by the China decoction itself. For 
my part, with respect to the sourness of juices I cannot recommend 
this dietary method with any but the greatest approval. But because I 
am more often compelled by my patients themselves to administer a 
China decoction and a drying and extremely light diet is altogether 
necessary for them, you will quickly realize that I had to alter the 
regimen; from the entire prescription I therefore had recourse to 
sweat baths, the slightly acid raisins, almonds, pine nuts, and toast, 
but not keeping honey that has been cooked, pulled, and drawn like 
sugar sticks. 

I shall not write down what weight or quantity I used of each 
ingredient, since you know that in this respect much has to be 
assigned to the nature of the disease and the habits and strength of 


the patient. In addition, when the decoction is first taken and just 
before the end of treatment, much differently from the middle of 
treatment, nearly everything should be altered, except that on the days 
when purgative drugs are administered patients should be indulged 
to a great extent; and you agree with me that the doctor’s judgement 
should be free in no matter as much as in the weight of food. 

What drink is useful 

The drink, as was mentioned in the preparation of the decoction that 
we mentioned, prefaces the decoction itself, which is presented in 
sufficient quantity lukewarm at luncheon and supper and whenever 
an otherwise troublesome thirst is present. Though the originators of 
the China wished patients to sleep as if their strength or other occa¬ 
sion did not produce much effort, wine diluted with a decoction 
of China should be served at lunch and supper. In accordance with 
this rule the Emperor would generally take a first drink or swallow 
of wine mixed in this way and the second of the decoction by itself. 
Because of weakness of the stomach on account of cold, Ludwig 
Sanches , 36 whom I previously mentioned, appeared to be heavily 
affected by so great a force of water that wine also had to be given to 
him, sometimes after he had first chewed a portion of a medication 
consisting chiefly of three kinds of pepper; sometimes the medication 
came from the juice of quinces in a formula described by Rhazes 
where the medication was at first omitted from the book De sanitate 
tuenda and afterward at the urging of his friends added to the end of 
the book of Galen . 57 

36 See n. 25 above. 

37 Like some other sentences in the Epistle, this one is murky in the Latin. De san¬ 
itate tuenda in six books is a work of Galen. The Persian author Rhazes or Razi 
(865—925) is described here as if he had edited, translated, or annotated the much 
earlier work of Galen. 


Sleep and wakefulness 


Those who take the decoction for sleep make the best use of night¬ 
time if they begin medication about two hours after supper. Those 
accustomed to sleep in the afternoon and who feel no harm there¬ 
from, do not have sleep entirely denied them also at that time; so 
after sweat has been wiped away and energies more or less relaxed, 
a great many get a quiet sleep. You will thus easily guess that dif¬ 
ferent kinds of sleep are recommended not so much for the sake of 
habit as because of the diversity of illnesses to which patients are 

Movement and rest 

You will learn from those to whom we prescribe guaiac that exer¬ 
cise and rest should also be varied according to the temperament and 
makeup of those taking the decoction. 

Concern about bodily wastes 

Again from the use of decoction of guaiac we are also concerned 
about the purgation of wastes. We have already discussed the stim¬ 
ulation of sweat, which generally comes only or in greater quantity 
on the first days, and with which the impurities, which we know 
adhere to the skin after their unperceived expulsion, easily soften 
and are washed away as if in a bath. So far as concerns the purging 
of impurities of the eyes, ears, nose, mouth, and teeth, massage of the 
hair, which is the action of soothing with a comb, and washing of 
the face and hands, nothing is changed from the custom which one 
observes in time of health from the teaching of preceptors who pre¬ 
serve health. Excretion of urine is not impeded by use of the China, 
though it has less of a faculty for removing urine and setting it in 
motion than I hear attributed to it. At the start, as also in the use of 


a decoction of guaiac, when as I was saying the sweats come out in 
the largest quantity, the urine is redder but presents its native color 
with the passage of time. The greatest care must be taken that the 
stomach respond as it should. In some patients it tends to be more 
compact, especially at the beginning and soon after purgation and 
when we perceive the sweating and urine are being drawn out in 
greater quantity. 

At this point I cannot sufficiently admire those who were the 
first to prescribe a decoction of the China, that they wanted to assist 
retention by the intestine and directed that individual decoctions of 
the China, which should be employed at the time when the stom¬ 
ach is contracted, be cooked with half a dram of celery root together 
with the China; that is how I understand “half of an eighth of an 
ounce,” which we read in their prescription. As celery root brings 
some assistance in stimulating urine, it also dries the feces of the 
intestine more rapidly and makes the intestine less prone to excre¬ 
tion. It is equally admirable that they recommend that injections 
or enemas be introduced into the intestine; these are not brought 
from the shops of pharmacists, as they write, but from an extracted 
liquor or water of chicory or borage, with a small quantity of rose oil 
added, or if that is not available, prepared with ordinary oil together 
with salt. It is not at all different than if they had suggested that every 
drying and sharp medicine should be avoided like an enemy and 
their special goal had had a view to the acidity of humors. So far 
I have not had these waters injected in a patient; but to conjecture 
from the guaiac decoction, I would order a decoction of the China 
to be introduced into the intestines with a coarse sugar, sometimes 
together with honey made from roses, and common olive oil (unless 
it happened that a calculation called for something medicinal), 
whenever I believed it opportune that the intestine should be evac¬ 
uated with a clyster. Because I have found the power of the China to 
be so senseless in the first faculties, I have more than once provided 
it reduced to a powder to be introduced into the bowel in the same 


manner that we mix a powder of guaiac for the same purpose to 
some other patients who are suited to this treatment, and provide it 
as a purgative drug. 

What affects of the mind are applicable 

So far as concerns mental affects, I want all who use the China to 
have an active life and to keep away all grief and every care in that 
solitude and circumspection comparable to a prison, though I am 
not unaware what a difference in the treatment of diseases is made 
by torpid, idle, relaxed emotions as distinct from those that are large, 
agitated, and heavily occupied. The presence of friends greatly helps 
those who are using a decoction of guaiac, especially those suffering 
from the Gallic disease; long conversation about pleasant topics and 
subjects that entertain the mind; likewise sport, with which one can 
restore oneself without great mental concentration or a discerning 
anticipation of successful outcomes. You will find certain games like 
the robber game 38 which I know reduce the strength of the primary 
faculty no less than the most arduous and difficult pursuits in the 

Sexual activity 

When I first chose the method of administering the China decoc¬ 
tion, I could not be sufficiently surprised that no one employed 
sex; women who could have aroused to venery were kept at a great 
distance; this was often repeated. Reasons occurred to me, however, 
that would persuade those who employ guaiac to think about other 
things besides sex. The sharpness of the humors that accompany 
the Gallic disease and the temperature which is known to stimulate 


Latrunculi , a Roman game of “robbers” somewhat resembling checkers or chess 

bilious and melancholic men to excrete semen seem a less effective 
argument than one could make. But when I put the China to use 
for a certain length of time I believed that precept should not be 
casually ignored, for it is astonishing how much men who drink 
the China decoction have erections. This is especially the case if a 
diet that is not thin, drying, and especially choice is begun at the 
same time, but patients are fed as if in a rapid relaxation of the mind, 
without drying, with much reclining on the back. It is likely that 
in this case a decoction of the China, which is otherwise so spongy, 
can accomplish something by its dampness; not so for guaiacum and 
other substances that can be given with it for the same use according 
to method. I was therefore unwilling now to neglect this rule, espe¬ 
cially when I knew that some, while employing the China decoc¬ 
tion, were so aroused to venery that though they had long refrained 
from sex and had avoided it for various reasons, did not abstain from 

How long the first decoction should be used 

I am well aware that you anticipate it will finally be asked how long 
we administer this decoction whose preparation I explained above. 
The rule from which I learned the use of the China sets forth an 
interval of twenty-four days. I have adopted this for my choice and 
judgement, just as I believe skill is located in the method and rea¬ 
soning of each person managing a treatment. Since that time, I have 
not known others except the Emperor who have used this decoc¬ 
tion. In fact, I have thought the treatment should be extended by 
more patients for more days, hoping for an accordingly better suc¬ 
cess, since I could not at other times oppose its use. Just as I previ¬ 
ously believed that before using the decoction the patient should be 
evacuated with appropriate purgations and if necessary with blood¬ 
letting, so too I observe that the purgation should be commenced 
for more or less ten days according to each patient’s nature. Likewise 


we end a treatment with this decoction by a purgation; how seldom 
that is the same, you know well from your particular diligence in 
medical work. 

A method of preparing and taking a second decoction 


I believe you recall that I wrote when the decoction I just men¬ 
tioned was to be strained, the pieces of the China which had just 
been boiled should be put away somewhere for another use, namely 
for the preparation of a new or second decoction. After someone 
has fully used the first decoction, after about ten days have followed, 
a second decoction, whose method of preparation I shall now add, 
should be taken at the time allotted for the drink. Two ounces of the 
previously boiled pieces that have been dried in the sun or shade 
are steeped for twenty-four hours in twelve pounds of a select water 
in the pot that we previously used and then cooked over a slow, 
smokeless fire until a little more than a third is evaporated. When the 
water has been passed through a strainer, it is given as a drink, and 
the same decoction is duly supplied according to the prescription on 
each day. The duration of this use is not so long in the bedroom or 
even indoors, nor is the observance of a diet or stimulation of sweat 
or urine, as was the case with the earlier decoction. As those who 
prescribe the method of administering the China decoction say it is 
suited to remove ulcers extremely resistant to healing, they also have 
not neglected to recommend the method of use with which we 
employ guaiac to treat the Gallic disease when it attacks with many 
malignant ulcers: they bathe the ulcers with a decoction of the 

China and cover them with towels soaked in the decoction. In this 
matter I have set out neither to praise nor disparage the China, since 
the occasion has so far not been given me to test it fully; I would 
therefore not provide it to any who have broken out in diseased 
ulcers or otherwise resist treatment and who are at the same time 


extremely ravaged by the Gallic disease. I am not unaware that some 
have made little progress in a similar treatment for sores, and I have 
long known that treatment of a slight ulceration or a kind of sore 
behind the ear has been tried without success. 

I also do not know what common ground there is between the 
juice of the China and the method of treating sores; I must acknowl¬ 
edge the China has no manifest qualities of cleansing or drying, though 
its qualities are also inconsistent. Still, it would be useful for me at one 
time or another to apply the China decoction to bodily members 
that are in pain one way or another because perhaps it has succeeded 
more as a warm fomentation than for another secret power. Just as I 
have not yet undertaken to cook the China in wine, so too I have not 
added another medicine to it, such as the root of sorrel, cyclamen, 
frankincense, lavender, and some others I have sometimes heard have 
been mixed with guaiac when it was hoped guaiac would accomplish 
some more extravagant special effect. For as guaiac has always worked 
well for me by itself, so too I have not believed it should be intro¬ 
duced in a new remedy. 

A way of administering Sparta parilla 39 

To this category should definitely be assigned a remedy that is praised 
to the skies by many, particularly merchants, as have many who have 
returned here from Portugal. I know nothing at all about the type of 
stalk that I could compare to any plant of ours; the root is short and 
densely covered with nodes; it puts off from its lower side long twigs 
like continuous simple branches instead of roots. From its upper side 
grow a large number of stalks next to each other, which we could 
compare to dried-out shoots of hops, : except that the cortex is more 

39 Better known as sarsaparilla (Smilax regelii), a popular treatment for syphilis when it 
was introduced from the New World. 



or less divided into squares like the mulberry and sometimes appears 
without thorns. It is seen to grow in marshy places and to need a 
support to hold it up like viny plants. I have not yet seen its leaves or 
flowers: only the root with its stalk-like stems, of which more than 
twenty-five grow from one root that does not exceed the length of a 
palm and the thickness of two thumbs; throughout its length it does 
not divide into branches. The whole stem was a forearm’s length for 
ease of carrying or convenient gathering in bundles without break¬ 
ing, and tied together like vine trimmings. If it is ever unfolded, it 
is about the length of a man if the tips are off. So far I have been 
able to see only the one stalk sent to our residence from Portugal; 
a label written in French was attached that indicated the stalk was 
called Sparta parilla (to the Spanish it sounds like a low mulberry 40 ), 
imported from India with great usefulness to mortals; it cures every 
kind of disease, especially the Gallic, if one having first taken the 
right purgation in the judgement of the doctor in attendance and 
according to the nature of the disease suffered, cooks an ounce of 
this stem in two measures of water, and drinks a twelfth of a pint 
of this decoction hot in the morning and before supper, and finally 
takes it as the beverage at lunch and supper with no use forbidden 
of foods that we recommend to those who are otherwise healthy. 
In addition, to those who used the decoction, free egress from the 
house was granted and it was added that the decoction was a sig¬ 
nificant remedy when applied to ulcers and painful limbs with the 
help of towels that had been soaked in it. Near the end of the dos¬ 
age, which was recommended to the twenty-fourth day, as well as 
at the middle of the time, a purgation was to be presented. Nothing 
further is written on the label, but it is perfectly clear that the writer 
or author wished to set down about the same method of treat¬ 
ment and usage that he knew is observed in presenting the China 

40 Sp. zarzaparilla, a small, brambled vine, a member of the genus Smilax. 


decoction in the same place from whence we have this Sparta parilla 
sent over.You may say that these stalks or shoots are utterly tasteless, 
no less than the China; indeed they are far more lacking than the 
China in any manifest quality, which is justly wished for in medica¬ 
tions of this kind. For that reason I have so far not considered their 
risk worth taking, since a person to whom these cuttings have been 
sent by friends instead of by divine aid will soon appear cured of the 
Gallic disease by a decoction of guaiac. I hope I may be permitted 
to leave these cuttings alone and take some portions of them to send 
to the friends so they may ponder these Indian impostures and offer 
them to other doctors. 

Native and familiar drugs should be put to use rather 
than exotics 

This is what has occurred to me to write about the China.We should 
take things of the kind that should rather impel us persistently to the 
native and familiar and whose effect upon conditions of that type is 
known to us, into our experience rather than advise patients to use 
those unknown, arid, insipid, and quite odorless roots or stalks which 
for a while come at a very high price.You would scarcely believe how 
successfully Stephan de Casala, the Emperor’s surgeon, employed the 
root of quinquefoil, which we commonly call tormentillad 1 on some 
paupers, giving its decoction for several days in the morning with¬ 
out any great dietary regimen or bed rest; ulcerations were promptly 
cleansed by this decoction and then covered with a common plaster 
which we call triapharmacum because it is made of vinegar, oil, and 
litharge . 42 

41 Cinquefoil or tormentilla erecta, a common weed thought to have antispasmodic, 
astringent, anti-inflammatory, diuretic, tonic, antiphlogistic, antiseptic, and hemo¬ 
static properties. 

42 Litharge is an oxide of lead, PbO. 


Decoction of Chamaedrys 4 ' 

I also cannot condemn a medication that was given in its own time 
and praised by the nobility at Geneva like something divine; it was 
sent with the greatest promises of a permanent removal of joint dis¬ 
ease a few months ago by Mr. Marzilius Colla, master of the Emperor’s 
horses, who is worthy of better health because of the many mental 
gifts with which he is endowed. 

Now it has been administered to the Emperor in the same 
way, so that he is said with the greatest certitude (provided he shall 
have put this medicine to use) to be immune to joint disease. The 
entire description is, I swear, quite empirical and contains nothing 
other than a purgation to be carried out at the beginning; then it 
calls for leaves of chamaedrys or low oak that is still green to be 
cut up if available (though I consider it preferable when dried, as 
with other herbs possessing the faculty of drying), then cooked in 
white wine; one twelfth of a pint of this decoction should be given 
in the morning, three hours before lunch. It should be added that 
more is to be hoped from such a medication, the earlier it is taken 
before lunch. In the dietary plan, acids and salts are forbidden, and 
drinking of this wine is prescribed for sixty days. It is added that the 
distilled liquor of low oak, or water, is compared in strength with 
the wine (which seems ridiculous to me), and accordingly water 
should be given to those who dislike the decoction. The label sent 
here has nothing else in general except a remarkably pretentious 
title and a long list of people treated by it, who by using it have lived 
many years immune to joint disease and who began using it when 
it was delivered. Cardinal Doria^ was a leading figure in this group. 

43 Teucrium chamaedrys or wall germander, native to Europe and the Near East, was 
used for the treatment of gout. The name chamaedrys derives from the Greek 
“ground oak.” 

44 Girolamo Doria (1495—1558), son of Admiral Andrea Doria (1466—1560). 


Dr. Ludovicus Panizza , 45 a famous doctor of my age, advised the 
Emperor at Mantua to use many medicaments, especially terebinth, 
of which a portion should be eaten daily in the evening for the 
space of a year, observing a suitable dietary regime at the same time 
and repeatedly taking purgative medicines. You are well aware how 
fruitlessly such precepts are written for the Emperor, as you have 
known his habits and way of living for many years now. 

No small results can be expected from genuine 

My colleague Dr. Gerard , 47 considering his particular devotion to 
simple medicines in otherwise severe matters, showed me among 
other medicines that he took with him from his embassy to Turkey, a 
medicine called rha by Dioscorides 48 and rhaponticum by Latin authors. 
It is not the root which the learned count among simple medicines, 
greater centaury , 49 but a thinner root than the common rhapontic, 
redder, spongy, rather smooth, and not very odorous; such odor as it 
presents is pleasant, more or less like that of rhubarb. In a large amount 
of it there is scarcely a piece spoiled by worms or rot. When tasted it 
becomes sticky with a mild but quite noticeable astringency; when 
chewed it produces a pale or yellow color like excellent rhubarb; when 
broken it quite elegantly resembles the finest rhubarb with a complex 

45 Ludovico Panizza, a physician in Mantua, author of De minumtione facienda (1556, 
1561) and other works. 

46 A form of rhubarb used medicinally, now chiefly for relief of menopausal 

47 GerardusVueldwick (see n. 32 above). 

48 Dioscorides Pedanius, the lst-century botanist who called this rhubarb pd because 
it grew near the river Rha (mod.Volga). 

49 So called because its medicinal properties were said to have been discovered by 
Chiron the Centaur. 16th-century herbalists assigned the name Centaurion maius (by 
some confusion) to a composite plant or plants (OED). 


and series of veinlets or red lines with white interstices, unless in this 
rhapontic a distinct and alternative color appears that is brighter and 
more pleasant to the viewer. Also, when taken it induces no nausea. 
So when those who have begun to administer guaiac and afterward 
have wanted the much-praised China are seen to suggest the strength 
of the medicines from Dioscorides when he lists the quite appreciable 
and much different faculties of rhapontic, I hope I would do what is 
worthwhile if in the treatment of Gallic disease I would sometimes 
begin to use this: especially since it is known to Dr. Gerard where, 
except from the mountains of Germany that lie close to us here, or 
from the common hypolapathus, 5 " which (unless it is also rhapontic) 
is cultivated in the gardens of my country under the name rhubarb, 
one’s own substantial supply of this rhapontic can be obtained. I for 
my part believe no slight hope can be placed in this rhapontic with 
the little risk that I have so far taken in treating the several conditions 
that Dioscorides enumerates. For this reason I think I shall write to 
you from time to time more about the actual method proceeding 
from our craft than I shall for the present about the foolish China or 
Sparta parilla. In the meantime, as earnest money there will be pieces 
of rhapontic and some stems of Sparta parilla which you will now 
receive with this letter since the China is for sale everywhere among 
the people of Antwerp. 

But now the times are upon me when I must busy myself 
not so much with cures, where it is appropriate to bring rhapontic 
into our experience; instead I shall be compelled to make trial of 
terebinth, which has been introduced with the warmest recom¬ 
mendation by Gerard, and with gums and resins as well as certain 
metallics. For in the war which the most excellent and merciful 
Emperor has instituted to pacify affairs in Germany with great 
armaments but no less a mood (so may it be for all) that desires 


A cousin of rhubarb. 

harmony and peace for all Germany, I am not greatly distracted by 
Gallic disease, obstructions of the organs, or chronic weakness (such 
as otherwise keep me worried most of the time and at length). I 
have instead dealt with bone fractures, dislocations, wounds, and 
other such matters which often attend such sport now, except for 
such anatomy as comes along by chance and is esteemed only by 
empirics. Seeing these things, I cannot resist now and again apply¬ 
ing my surgical hands to a task; I am otherwise forced to keep my 
hands off in those conditions in whose treatment we perceive the 
true strength of medicine to lie. So distorted are the judgments of 
men who contend that the hands have nothing to do with medical 
work. Weight is given to this opinion by doctors who have noth¬ 
ing to do with medicine except with certain drugs that relieve the 
bowel, syrups that prepare humors for evacuation, and with sev¬ 
eral evacuating medications and some formulas for pricking and 
fomentations; these doctors increase the great hauteur with which 
they conduct silly arguments about which vein should be cut open 
in sickness. Moreover, these pestilential men are so dependent 
upon calumny that if they notice that someone knows things they 
do not, they admit that he is indeed an expert about those things, 
but they deny he is a doctor (which they are themselves in name 
only). It is as if someone who is truly to be considered nothing less 
than a doctor will finally become a doctor; and as if a person more 
accomplished in the earnest study of one of the medical disciplines 
would be resistant to the remaining knowledge of medicine. I know 
to what degree some on account of expertise in languages, others 
through mathematical studies, others through the constant exam¬ 
ination of simple medicines, have been exposed to scorn by the 
most ignorant of these, doctors gaping at nothing but profit who 
have put their studies far behind them, in the company of Princes 
to whom these experts have been commended on other occasions 
by those present. 


Hapless people who gratify themselves by publishing 

You are also not unaware what a hindrance to me when I first came 
to court was the study of anatomy that had altogether lapsed in our 
time, and the efforts that I made affecting all medical students. But, 
my Joachim, the fortunes of mortals are as each one allows his fate 
to dictate , 51 and there is no one who does not think daily how he 
torments himself and wishes himself free of this life. What falls out 
of use with some, I believe is especially familiar to others who satisfy 
themselves by thinking about a subject and bringing it to light; and 
in this way those who do not know they should escape attention 
by being born and dying expose themselves to so many calumnies, 
and it is their doing that they daily hear about their writings things 
that hurt their feelings. I therefore bear it with greater equanimity 
that I live at court away from the sweet leisure of my studies and do 
not teach medicine at Pisa for a stipend of eight hundred crowns 
from the illustrious Duke of Tuscany Cosimo de’ Medici, the prin¬ 
cipal patron of the now largely declining disciplines . 52 I am just 
now in such a position that even if I strongly wished to do so, and 
no matter how strongly a self-love urged me, I am unable to bring 
41 myself to consider a new project or think about a publication. To 
pass over others and talk about myself, so entangled is everybody 
only in authorities and so few students of truth does this gener¬ 
ation have, and people follow the disciplines only through digests 
or more accurately time wasters, that I hear many are furious with 
me because in my writings I appear to them to have scorned the 

51 Viz. Each man’s fate is his own doing. 

52 Duke Cosimo had invited Vesalius to Pisa to present anatomical presentations. See 
O’Malley 1964, 197. O’Malley places the offer in the late spring or early summer 
of 1542, and Vesalius gave his course with great success in January—February 1544 
(Siraisi 1990, 164). The offer of a more permanent position with a salary of 800 
crowns came after those lectures (O’Malley op. cit. 199—203). 


authority of Galen, the prince of physicians and universal preceptor, 
and because I have everywhere rejected his opinions. Any error I 
have found in his writings, they say, I have reported. They are unfair 
to me and our studies, and likewise to our generation. Though they 
should have been glad for these things, because I was the first that 
had the courage to drive out false and untrustworthy opinion from 
the minds of men and to uncover the rare imposture of the Greeks, 
and because I provided a unique occasion for investigating the truth, 
nevertheless you will find many who take such a perfunctory look 
at my labors regarding the authority of Galen that they still argue 
(without examining the body) that nothing at all was written by 
Galen with anything but the highest truth. You have seen writings 
of many of the most learned men of our time who have publicly 
praised my youthful efforts far beyond their merit; they are happy 
to say that their trust is placed in their own eyes, not in the writings 
of Galen. 

Occasion for the letter of Sylvius in which it was 
declared that nothing written by Galen is completely 
in error 

But I understand there are many who even though they grant that 
I have provided something worthwhile and credit me with more 
than I recognize, nevertheless are grievously inflamed for Galen’s 
sake. Among them I would have counted anyone rather than Jacob 
Sylvius, the finest of the doctors of our time, had he not in a letter 
sent via your son attested to that reaction with extreme ardor, say¬ 
ing that he had read my work De humani corporis fabrica. You may 
now readily understand what I included in my letter to him which 
I sent to you at Nymwegen to be delivered by your son to Sylvius. 
You wonder what pages I sent to Sylvius, and if by chance the 
letter was only to Sylvius, what argument it employed, believing 
it contained something about our common interests, which you 



strongly wish to have told to you as well, as you are altogether eager 
to know about my trifles. I responded to Sylvius in that letter and 
added at length certain things which seemed to deal especially with 
the agitated mood of his letter. But everything was for the most 
part anatomical, such as observations by which things that caused 
him displeasure were explained away and were meant at the same 
time to show why I was unable to descend to his opinions. When 
your son departed for Paris to resume his studies and I recom¬ 
mended him in letters to Vasses , 53 Fernell , 54 Oliveri , 55 and others 
whom I most respect for their erudition, I considered Sylvius’ rep¬ 
utation among the best, as you also are aware. Besides my praise 
for your son I inserted other remarks about our common inter¬ 
ests, adding as well that if any things in my anatomical book were 
unsatisfactory in his judgment, he should let me know about them; 
because I thought it relevant also to him who has achieved a great 
name in anatomy among his peers if something was published by 
me, inasmuch as I enrolled in medicine under him. So it was under 
this circumstance that Sylvius wrote a letter in which he indicated 
in a standard and more or less formulaic way that he did not claim 
so much erudition or authority that in so great a matter he either 
wished or was able to be the arbiter; however, since I had set him 
up as the judge he would briefly disclose his opinion. Then, writing 
unfairly that I was belittling Galen, he listed the items by which he 
was particularly offended, namely that I had announced that Galen 
had not dissected human bodies; that he had observed the veins of 
the hand only in living persons; that the work De usu partium was 

53 On Jean Vasses of Meaux, the dean and chief administrative officer of the faculty of 
medicine at Paris, see O’Malley 1964, 37f. 

54 On Jean Fernel (1497—1558), who first used the word “physiology” to describe the 
study of bodily function, see Sherrington 1946. 

55 Otherwise unknown. See O’Malley 1964, 47. 

copied out of other books. Other things in addition were picked 
out of my preface where I assign censure to Galen because of doc¬ 
tors who follow him, none of whom has been found who does 43 
not agree with Sylvius, since he writes that he still believes that 
nothing wrong has been handed down by Galen. For this reason 
he wrote in his letter that in all the places where I said that Galen 
had falsely or wrongly written his description of the human body, 
or passed over something, or offended in an untrue account of the 
use of the parts, or invalidly attributed groundless reasons to the 
strength of his opinions, Galen was totally free of any fault. 

I should have expected such an opinion from anyone but him, 
because after being warned, and now again teaching medicine out¬ 
side his usual way of thinking, from the beginning, when Anatomy 
quickly comes into the picture, he should have been so zealous for 
truth that although he had perhaps read the books of Galen out loud 
many times already without finding anything wrong, he might now 
have begun to scrutinize them differently, set aside his piety (as befits 
a lover of truth), and compared the things I was saying in dissections 
of bodies; or if because of his aged condition reading occupied him 
by itself more than enough, at least he should have asked his students 
to make an inspection. I cannot accept what he writes, that he took 
every precaution at the university to prevent the least suspicion from 
creeping up on the listener thatVesalius was singled out by Sylvius 
because he has great love for me, esteems me, and wishes to keep me 
as his friend provided I free Galen of false accusations and place the 
blame either on my youth or on the zeal of Italians who wish Galen 
ill; for he intimates that he and I cannot agree unless both of us agree 
with Galen, adding besides to increase his apprehension that even if 
he said nothing himself, the walls nevertheless would tell their opin¬ 
ion about my nighttime labors. Several of his students in Anatomy, 
he writes, who are extremely proficient in his point of view are 
sharpening their pens against me, being indignant that any fault has 


been found with the universal patron of physicians. He therefore 
wished to be told what I wish him to do in this matter on my behalf, 
how I would like him to issue a retraction and avert the sharp 
pens of his disciples from me. Thus, my Joachim, you have the story 
in plain view; it did not call only for the dense and lengthy letter to 
Sylvius, but for a book: not only to refute his judgment but also to 
lay open to the most experienced students of anatomy (if it please 
the Gods) the argument by which they may at last sharpen their 
pens when they have undertaken a dissection with sharp scalpels 
as diligently as I have done and consider without prejudice things 
that were set forth with the greatest candor for the chief purpose 
of aiding their studies, comparing the places accurately; so that they 
should not be occupied simply in praising Galen and deceitfully 
avoiding matters that I wished to be common knowledge to stu¬ 
dents. But I am not so ignorant of things, nor did I so casually notice 
Titus Livy’s praise of the Carthaginians or Homer’s praise of the 
Trojans, that I did not think it should be stated in every way and as 
much as possible with my sterile and meager diction that Galen is to 
be declared so to speak the author of all good things, the rare miracle 
of Nature, and the prince of physicians after Hippocrates, the chief 
and leader of professors of anatomy To such a degree do I hold this 
view, that greater glory has been set in store for me from those who 
come after, among whom I expect to find the diligence of Galen in 
so many countless places: Galen, the foremost of all who have come 
after him. Therefore nothing can or should be more pleasing to me 
than the praise of Galen, and I yield to no one in my piety to him 
and deferential regard. 

Neither Sylvius nor any disciples of his whom he talks about, or 
whose names he has decided to abuse, should have occupied them¬ 
selves in reeling off Galen for my sake. Things falsely attributed to him 
that they esteem because of the tender devotion we excessively pre¬ 
serve toward authors, should rather be recalled, put onto the anvil, and 
judged with exact and tireless diligence so that by this means others 


may be spurred to the study of truth and I may be clearly warned if I 
have not made sufficient observation. 

This should not be as if I had started a fight with Galen, and I 
should not grieve too much that we have been so tricked by him that 
I have been exposed to scorn and finally so overwhelmed by some 
common theories. 

Occasion for the opinion } here to be recorded, of the letter in 
which Vesalius replied to Sylvius 

I will gladly write down how I briefly refuted those theories in the 
letter to Sylvius, since although I have not saved a copy of my letter 
(I had replied quickly because of the opportunity for a messenger) I 
shall at least put its content as I do into the letters which I send to my 
friends from time to time concerning my activities or which I write 
to patients or other doctors about the treatment of certain compli¬ 
cated conditions that have some pecuhar feature, in the form of a 
consilium , 56 as we call it, and sometimes I excerpt. First, I wrote that 
I was the less disturbed by the letter of Sylvius the more I had seen 
the most learned doctors and philosophers in the process of dissection 
say the same things as I have about Galen, and he took them with 
the same displeasure as he did me. They considered it incredible that 
this father of medicine had committed such errors in his Anatomical 
volumes, and that he had written them diligently and precisely, and 
with great self-approval, and it was believed even while he lived that 
what was in such an account more than in any other would always be 
true. But with the passage of time those critics began to grow softer, 
nor was there anyone in so great a number who went on to correct 
Galen when there was a body present and with the greatest reluctance 

Examples of such consilia and letters to patients are translated in O’Malley 1964, 



place greater trust in his own eyes than in the writings of Galen. So it 
was that I hoped Sylvius would change his opinion a little later as he 
gradually went on with his reading of my book, and for that reason 
would not exclude me from his patronage and love. But if it should 
undeservedly turn out otherwise, I wrote that whatever that was I 
would count myself among the calamities of the human race because I 
had heretofore not learned to lie and speak contrary to the opinion of 
my mind, especially when I perceive that the things which he blames 
in me are daily increased and in no way remove my age (which I 
know perfectly well has grown beyond the youth that was thrown in 
my teeth by Sylvius) from his opinion. I need not say why I should 
have been so disturbed that he offered some excuse in the pretext 
that the Italians wish Galen ill. The fact is that the divine genius of 
the Itahans cherishes and reveres nothing so much as Galen, as they 
have abundantly shown by the publication of his works, though at the 
same time the Arabs do not entirely despise him, and they should not 
by any means be kept out of the hands of medical students. I should 
therefore deserve to be considered utterly impudent if I put the blame 
for my negligence (if any of the things of which I am accused occurs 
in them) upon such learned people who deserve the best from me and 
are so friendly to me. They no less than Sylvius now were accustomed 
to oppose my views when they first attended my dissections, nor is 
there any of them whom I had ever seen put their hand to a body; 
they themselves will know well that in this narrative none of them 
was my teacher or accomplice. 

Galen did not dissect humans, hut teaches the study of 
animals instead of man 

I therefore attempted to show in my letter to Sylvius that although 
nothing more weighty or impressive can be said about so great an 
author, Galen did not teach the fabric of the human body, nor is 

it even likely that he had ever witnessed a human dissection. For 
though he writes that he had seen the dried-out cadavers of two 
men suitable for study of the bones , 5 he nowhere makes mention 
of dissected humans except for the body of a German soldier (whose 
dissection he did not attend ). 58 It is known instead that his account 
is based on the bones of apes, not humans, as is obvious primarily 
in the differences that we see between man and the ape princi¬ 
pally in the parts or places where Galen described the fabric of the 
bones in such a way that it has been possible for us to note certain 

A number of conjectures from the bones 

I had next put together some examples of these differences by loca¬ 
tion in my letter to Sylvius as they came to mind, just as if I should 
now : say on the basis of various passages that now come to mind 
that Galen describes a suture in his account of the bones of the upper 
maxilla that goes up from the middle of the perimeter of the eye 
toward the middle of the eyebrows and is perfectly visible in dogs 
and apes but not in humans; these differ in various ways from Galen’s 
description of the eye sockets . 59 

57 See De anatomicis administrationibus Ch. 2.221, tr. Singer 1956, 3.This is the Galenic 
text thatVesalius had edited for the 1542 Basel edition. 

58 See De anat. adm. Ch. 5.385, tr. Singer 1956, 77. 

59 This difference is discussed in Bk. I Ch. 9 of the Fabrica. “Galen had described the 
premaxillary bone and suture of the dog as though present in man and thus could 
not have been familiar with human anatomy. Vesalius thus opened a great contro¬ 
versy of singular importance in comparative morphology, which was to rage with 
bitter polemics for nearly four centuries and to be settled only in recent times. ... 
His discovery, from which he made the correct deduction, was one of the major 
factors leading to the overthrow of Galenical anatomy.” (Saunders & O’Malley 

Moreover, another particular suture 60 is told of in simians and 
those animals that have long, protruding canine teeth, that passes 
between the canine tooth and the incisor nearest to it and is com¬ 
mon to a suture that runs 
transversely in the palate 
of those animals from one 
canine tooth to the other; 
since man, who has an oth¬ 
erwise very short jaw, lacks 
these sutures, we cannot 
with Galen ascribe to man 
a special bone in which 
the incisor teeth are fixed. 
In addition, Galen wrote 
incorrectly that the suture 
running to the canine 
tooth from between the 
brows is borne in a con¬ 
tinuous path when in fact it takes its beginning from about the middle 
of the suture that ends at the outer side of the nasal bone. 

In the foramina of the skull there is a major difference between 
man and the ape. But as Galen considers the differences too hastily, 
we can gather very few principles into our way of thinking from his 
account of the foramina.Yet at this point the difference in the foramina 
transmitting the principal branches of the carotid arteries is scarcely to 
be passed over, since it is seen that they are carved out transversely in 
man and by the great diligence of nature over a long course, whereas 
in apes they are more or less straight , 61 rather similar to the foramina 

60 The suture marked n [sutura maxillo-incisiva] in the figure of the canine skull above 
and in Bk. I Ch. 9 of the Fabrica, where Vesalius disputes the claim of Galen that it is 
found in humans. 

61 In his legend for the fourth figure in Bk. I Ch. 12 of the Fabrica Vesalius refers to 
Galen’s manual on the dissection of veins and arteries De venarum arteriarumque 


that provide a path for the nerves there. Galen observed the fabric 
even of apes so casually that he represented it far differently than it is 
in fact or than the artifice of Nature is seen to be in the course of the 
arteries, saying that the carotid artery has a common foramen with the 
third pair of nerves coming out of the brain. 

The sharpness or edge of the heads of the occiput in the dog 
or simian bone to which the first vertebrae are articulated is a 
proof that the skull of a human had not been examined by Galen: the 
human skull has those condyles protruding very little, extending from 
the back forward over a long course, meriting nothing less than the 
name Kopcbvri ; 62 but the condyles of the animals just named extend 
noticeably downward, and for that reason are rightly given that name 
by Galen along with the other heads of bones entering sinuses. 

The lower maxilla of a human can in no way be parted in its mid¬ 
dle by any method of boiling at the top of the chin as Galen had seen 
a number of jaws of quadrupeds separate into two distinct bones, even 
sometimes before boiling. And if Galen tells us the maxilla of a new¬ 
born baby is formed from two bones joined by symphysis or a seam, let 
us say so for the sake of piety . 63 We shall soon convict him of negligence, 

dissectione with the remark “I am especially surprised at Galen, who passed over this 
large foramen (among many others) as if it were not worth considering in passing.” 

62 Gk. korone, anything hooked (the word is also used for the coronoid process of the 
ulna). This paragraph refers to a passage in Bk. I Ch. 15 of the Fabrica where Vesalius 
takes issue with the 12th book of Galen’s De usu partium (4.1 ff), where in an unusu¬ 
ally prolix and sententious introduction Galen states (wrongly, as Vesalius points out) 
about the joint of the first vertebra with the occipital condyles that “It is immediately 
clear that Nature has prepared these concavities and protuberances for lateral move¬ 
ments in both directions” (tr. May 1968, 556). Galen concludes his prefatory observa¬ 
tions “No beneficent being bears malice over anything, but naturally aids and adorns 
all. So too, though I am not unaware that times without number this book will be 
treated spitefully and abused by foolish and ignorant men, like an orphan fallen into 
the hands of drunkards, I am nevertheless undertaking to write it for the sake of those 
few who are capable of reading and understanding it correctly and judging what is 
said.” (tr. May 1968, 559—60). Vesalius’ 1555 version would add to his criticism of 
Galen regarding the motions of the head over the cervical vertebrae. 

63 In Book I Ch. 9 of the Fabrica Vesalius disagrees with Galen that the human man¬ 
dible consists of two halves joined by symphysis, like that of most animals, and can 

because he did not say that the occiput of an infant, the bones that are 
knit at the sacrum, and a great many more besides are constructed of 
several bones in the same way, such as the vertebrae themselves. 

From this I am more strongly convinced that Galen had not seen 
the bone resembling the letter u [os hyoideum] in man, because this 
bone, besides the fact that it is very different from the bone in animals 
that is comparable to this character or rather the A and is formed of 
a great many ossicles whose connections and shapes require no ordi¬ 
nary study because of several muscles and on account of the voice, you 
will find none of these (except in animals) that you can readily com¬ 
pare to u,Y, or A because it is not constructed of other ossicles . 64 

We observe that the transverse processes of the seventh cervical 
vertebra are always perforated in man, otherwise than in some dogs, 
nearly all of them. It is clear that Galen followed the opinion of other 
anatomists that it is sometimes perforated and sometimes not . 63 

Because Galen saw that in apes the tenth thoracic vertebra is 
taken up on both sides differently than in man and believed that 
the two vertebrae placed beneath it lack transverse processes, he 

be separated by boiling. See Galen De ossibus Ch. 6 (2.754.15—18, tr. Singer 1952, 
771): “The bone of the lower jaw is not single, as one might think, for when boiled 
it too is separated at the point of the chin, so it is seen to be composite.” Fusion of 
the two halves of the human mandible at the symphysis mandibulae is completed in 
the human by the second post-natal year. 

64 In Book I Ch. 13, “On the Bone Resembling the Greek Upsilon,” Vesalius criti¬ 
cized Galen’s nomenclature but illustrated two very different hyoid bones, neither of 
which is typically human. The left hyoid in his illustration has features of the canine 
hyoid apparatus, which is an assemblage of ossicles joined by synchondroses. Vesalius’ 
distinction here between the animal hyoid constructed of multiple ossicles and the 
human hyoid which is a single bone was not made in the Fabrica. 

65 In De ossibus p. 758 Galen had written that the seventh cervical vertebra is rarely 
perforated. In the fifteenth chapter of the first Book of the Fabrica Vesalius had writ¬ 
ten “No vertebra of the human neck has so far come to my attention that did not 
possess a perforated transverse process. But I have frequently discovered processes 
of the seventh vertebra of dogs and apes lacking a foramen.” (He would omit this 
statement from his 1555 edition, which adds that they are rarely perforated in dogs 
and monkeys and adds to his critique of Galen). But the omission of this specific 


reported that it was likewise in man; but it is perfectly clear that the 
tenth rib is articulated to the tenth vertebra by two attachments, one 
of which belongs to the apex of the transverse process, which is why 
that vertebra does not lack transverse processes. The eleventh and 
twelfth vertebrae of the human thorax also have transverse processes, 
though extended much less than those of the vertebrae above . 66 

I will pass by the fact that Galen testified more than once (though 
falsely) that every one of the ribs is attached to vertebrae by two joints. 
But when we observe the vertebrae of humans, as well as apes, dogs, 
hares, and animals of that kind in the course of posterior processes or 
spines, as well as transverse processes, what could be judged more in 
conformity with the truth than that Galen had paid attention to the 
bones of those animals but not human bones? As he himself writes, 
we may see that the aforesaid processes of several of the lower thoracic 
vertebrae and all of the lumbar vertebrae run so obviously upward, 
otherwise than in man. Moreover, among the lumbar vertebrae Galen 
describes a particular process as a bulwark for the nerves that take their 
origin there from the dorsal medulla; it does not escape my notice in 
apes and dogs (whose lower thoracic vertebrae have that process), but 
I know very well that man does not have it . 67 

matter from the 1543 Fabrica suggests thatVesalius had subsequently developed his 

66 In Fabrica I Ch. 16,Vesalius wrote “In the transverse processes, the thoracic vertebrae 
also vary from one to another, but not so much as Galen stated in the thirteenth 
book of De usu partium where he deprived the tenth vertebra and the two beneath 
it of transverse processes.” See Galen De usu partium 4.78—83, tr. May 1968, 588. 

67 See the section of Fabrica I Ch. 17 titled “The extra process which Galen ascribes 
to the lumbar vertebrae,” citing book 13 of De usu partium and chapter 10 of De 
ossibus.Ve salius comments “I have never observed this process in human vertebrae; 
consequently, in investigating it I decided I should employ the same system and 
method by which I regularly investigate features described by Galen that I do not 
find in human anatomy, and which I perceive to be other than he stated. My prac¬ 
tice is to examine all of these in dumb animals, especially dogs (of which there has 
never been a shortage); these have quite often shown me what Galen described, or 
instructed me what he meant as if leading me by the hand. I was unable to find this 



The difference between man and ape in the fabric of the sacrum 
and coccyx cannot be explained in a brief account. But because no 
small amount of guesswork is necessary on that account, it will be 
useful to explain in at least a few words that Galen neglected human 
bones. In man, a large bone that is quite complex in shape lies beneath 
the lowest lumbar vertebra. This is made up of six particular bones at 
most , 68 that are so attached to each other by symphysis or coalescence 
that in humans of more advanced age there is no appearance of a joint 
in the posterior surface of the bone. 

But in the anterior region they exhibit a clear attachment that 
presents something in common with the meeting of the vertebral 
bodies.That connection is more obvious where the bones are attached 
as if to bodies (to compare it to the vertebrae), for where they are built 
together on the sides as with transverse processes, they scarcely show 
the line where they are joined. This series of bones becomes narrower 
as if from a wide base downward, unless one were to argue that the 
transverse processes of the second bone extend more to the sides than 
the processes of the first. The transverse processes of the three upper 
bones have both depressions and protrusions by which a close fit with 
the iliac bones is achieved. The upper surface of the bone is articu¬ 
lated to the lowest lumbar vertebra in the same way that we know it 
is joined to the vertebra lying upon it, whereas its lower surface rests 
upon a tubercle that is proportioned as if to the body of a cervical ver¬ 
tebra. Without another process it enters the depression of a succeeding 
bone, which with the three ossicles attached to it in order we consider 
to be the coccyx bone, just as we believe the bone that we were say¬ 
ing is made of six bones was called the sacrum by those who trained 

lumbar process until I undertook the complete dissection of an ape at Bologna for 
Giovanni Andrea Bianchi, and assembled its bones together with those of a human 

68 The human sacrum is more typically composed of five bones, though it may vary 
from four to seven vertebrae. Vesalius admits the possibility of five, but the Fabrica 
illustrated a six-bone sacrum. 


their boys at home in the dissection of bodies as well as learning the 
elements or letters. 

The joints of the four ossicles of the coccyx are like the joints 
of the vertebral bodies, and a cartilaginous ligament is present here 
much more obviously than in the joining of the bones of the sacrum 
which is completely lacking in any movement.The lowest ossicle ends 
in cartilage and is pierced by no foramen, as no ossicle of the coccyx is 
seen that is pierced. It does not admit the dorsal medulla or provide a 
path for nerves originating from it.The sacrum is carved out through¬ 
out its length for the dorsal medulla no differently than the vertebrae, 
and from its upper surface beneath the vertebra resting upon it the 
sacrum transmits nerves in the same way we know those nerves exit 
from the lumbar vertebrae to the sides. In the remaining structure of 
the bones of the sacrum, foramina are carved both to the front and 
behind for the exit of nerves; there are six apiece on the anterior and 
posterior sides of the sacrum, so common to the two bones attached 
to each other that the upper bone bears the larger portion of the fora¬ 
men carved into itself, unless sometimes the sacrum is formed of only 
five bones: in that case another joint of the first bone of the coccyx 
with the sacrum arises, from which a path is provided only in the pos¬ 
terior surface for the last nerves from the sides. 

The sacrum of the dog and the ape, which can be compared 
in shape to the sacrum of man, is made of only three bones, which 
make the same attachment to each other as in the human. The infe¬ 
rior side of the third bone imitates the lower region of the lumbar 
vertebra just as the upper side of the first bone resembles the upper 
region of the same vertebra. The ossicles follow the lower side of 
the third bone and are quite similar in shape to lumbar vertebrae in 
nearly all their processes, especially in the attachment of the bodies 
and what we call the ascending and descending processes, as well as 
in the foramina made for the dorsal medulla and the nerves growing 
out of it. These ossicles number more than three in dogs and caudate 
apes; they are then followed by the solid and imperforate ossicles of 




which the tail is constructed. It is different in the non-caudate apes, 
to which Galen provides three ossicles of the type that come imme¬ 
diately after the sacrum, but he does not dignify them with the name 
of coccyx. If therefore one compares his descriptions of apes with 
the fabric of humans, many things will come to light that will seem 
correctly written about apes but not agreeing with humans. It will 
immediately be concluded in other ways that Galen did not know 
about the six foramina made for nerves and at least three ossicles in 
man, and in addition he did not faithfully describe the construc¬ 
tion of the bones of which we grant he had knowledge. Yet we do 
say that Galen thoroughly understood the true account of the ape. 
I would also like to say something about the books De anatomicis 
administrationibus and De ossibus. In De usu partium, he counted only 
four of the nine bones in man, having no awareness of the coccyx 
either in humans or in apes. 

After this comes the pectoral bone [sternum], which in apes and 
dogs is made of seven bones that are quite clearly about the same in 
shape and size, not much wider than thick. However, the human pec¬ 
toral bone is extremely wide at the top and much thicker there than 
elsewhere and quite different in shape. Close to its end it is also wide, 
but not thick; immediately afterward it narrows into cartilage [processus 
xiphoideus ], not unlike the point of a sword. Halfway along its length, 
and chiefly on its upper side, the pectoral bone in man is narrower, 
and for that reason the ancients conveniently handed it down that it 
was lunate at its sides. Thus there is a very large distinction between 
the human bone and the ape’s, and you will not find seven bones in 
the human pectoral bone. Whatever their number is, they are attached 
by a much different type of connection than in apes. In them, the 
articulation of all the bones is the same, but in man the articulation is 
extremely clear where the first bone is attached to the one beneath; 
the connection of the other bones is hidden on maturity and quite 
obscure in children also, though quite different from apes in the type, 
shape, and length of the bones. When the pointed cartilage of man 


is not only brought forth between the attachment of the cartilage of 
the seventh rib on one side to the cartilage of the seventh rib on the 
other side, but also takes its beginning like that of a particular bone, 
this bone is so distinct from those above it that in humans of middle 
age there are three breast bones; and if it happens that the second 
bone seems in children to be constructed of many that are attached 
by symphysis, that articulation is not comparable in apes. 

I have already warned how much negligence occurs in the books 
of Galen if we have recourse to newborns and how they purge them¬ 
selves, though his description squares perfectly with quadrupeds . 69 

I have also looked at the somewhat bony cartilage of the true 
ribs in the very old; nothing bony appears in the cartilages of people 
of middle age as it does in dogs, apes, and sheep which have not yet 
attained their full growth, where bony and friable cartilages, and some 
only surrounded by cartilage as by a crust occur. So it is not surprising 
that Galen described bony rib cartilages of the upper ribs of animals 
but not of humans . 70 

By the same reasoning, if Galen had been with the Roman doc¬ 
tors when they cut up the German soldier and inspected his heart 
as he did that of an elephant, which he mentions at such length, he 
would certainly not have argued at such length that the heart has a 
bone, or at least he would have noted the difference here . 71 I should 
like it ascertained how evident the difference is when the heart of a 


69 Vesalius is recalling his critique of Galen in FabricaV ch. 17 regarding the second 
fetal wrapping or allantois and the urachus, the urinary canal of the fetus that after 
birth becomes the median umbilical ligament. It is described by Galen in the 15th 
book of De usu partium 4.231.7 ff.—240.12, tr. May 1968, 664—69. Vesalius would 
rewrite his chapter on the fetal wrappings in the 1555 Fabrica, with special attention 
to the urachus. 

70 See Ch. 19 of Book I of the Fabrica under the heading “Cartilaginous Substance,” 
where Vesalius distances himself from Galen’s description of rib cartilage in 

71 The matter is discussed near the beginning of Ch. 20 of Book I of the Fabrica. See 
Galen’s De anat. adm. book 7 (§618—20) “The bone in the heart, which people think 
is present only in large animals and not in all of them, is there in others too, yet 


decrepit ox or rather a stag is available together with a human heart; 
then nothing would prevent finding out whether the bony substance 
in a deer’s heart and the ossicles themselves differ from the human. 
But I should be unwilling here to complain against anyone, if he had 
observed a substance in the heart of a decrepit old man that he could 
reasonably compare to a hard cartilage, as it is surprising how much 
softer the total constitution of man is than the dry animals just men¬ 
tioned, and how long man exhibits soft cartilages and joints made by 
symphysis in which cartilage plays a part. 

When we make an examination of the scapula and its pro¬ 
cesses and it is known to us with the greatest certitude that its higher 
process [acromion] to which the clavicle is articulated has been called 
the summus humerus by the leading anatomists, is it not clearer than 
54 light that Galen, misled by what Hippocrates said, in the joint of 
the clavicle with that process ascribes a third bone to humans that 
apes lack, contrary to the fact of the matter, and which had been 
called the summus humerus by Hippocrates?' 2 I make no mention of 
many conflicting opinions of Galen besides this joint and its process. 
For when Hippocrates said that the summus humerus was given only 
to humans, having conjectured from cattle, dogs, sheep, pigs, hares, 
horses, and quadrupeds of that sort which occur commonly, he no 
doubt meant the upper process of the scapula to which the clavicle is 
attached, since it is quite certain that those animals lack that process 
as well as a clavicle. 72 

sometimes not quite as a bone but rather as a cartilage. ... An elephant of the largest 
size was lately killed in Rome .... When the heart was removed by Caesar’s cooks, 
I sent one of my colleagues, experienced in such things, to beg the cooks to allow 
him to extract the bone from it. This was done and I have it to this day.” (tr. Singer 
1956, 186-7). 

72 Sic: As they wrote in Greek, the Hippocratics called it the acromion: De articulis 2.8, 
3.21, etc. On the ambiguous use of this term in antiquity to refer to the process 
we call the acromion or to an abnormal sesamoid bone concealed in the acromio¬ 
clavicular articulation, see May 1968, 612 n. 51. 

73 Vesalius alludes here to a section titled “A third bone enumerated by Galen in the 
joint of the acromion with the clavicle” in Chapter 21 of Book I of the Fabrica. 


But when Galen observed that process in his apes (no doubt 
because they, like man, have clavicles) he held Hippocrates in such 
veneration that he imagined a third bone exists in humans in the 
place mentioned, thinking that Hippocrates in his account had com¬ 
pared man to the ape, as he had to other quadrupeds that are served at 
the table. If this had been done by Galen, I would not have searched 
so long in vain for the third bone in man, nor for the same reason 
would the opportunity have presented itself in this part for me to 
conclude that the father of anatomy had not examined the cadav¬ 
ers of humans, though a truer description of the humerus along its 
length (for he does not always agree with himself) would likewise be 
attested in Galen, since what he wrote is applicable more to the dog 
than to man. 

Similarly, Galen shows that he observed the carpal bone [os 
pisiforme] which I count fourth in the upper order, and which is 
called by Galen the upright and cartilaginous bone, 74 in the ape but 
not in man. He ascribes to it alone that it is the bulwark of a certain 
nerve [ramus palmaris nervi ulnaris ] that curves from the outer part of 
the arm to the inner. I am not unaware of that nerve, but in humans 
it does not contact the bone itself, and much less does it twist along 
it. 75 * 

Instead, it passes a little below the middle of the forearm from its 
inner side to the outer before sending out two offshoots to the little 
finger and the ring finger and one to the middle finger on their outer 
side. It is a branch of the nerve that I identify as the fifth [n. ulnaris] of 
the nerves entering the upper arm. 

I am now immoderate in enumerating the ways in which man 
differs from the apes, so that I may show that human bones were 

74 Galen’s Trpo|jriK8s octtoOv (De usu partium 3.131.13, 134.3.) and xovSp£>Sss ocrroOv 
(De anat. adm. 271.6, De usu partium 3.135.8,136.1), described in Book I Ch. 25 of 
the Fabrica .The passage in De usu partium thatVesalius criticizes here is 3.134.3 if., tr. 
May 1968, 137 f. 

75 Vesalius makes this point in Fabrica I ch. 25, p. 118. 


unknown to Galen. It sufficed Galen to consult himself in the place 
where he hands down the book he wrote De ossibus, when he has 
diligently inspected one by one what each bone is and what it is like, 
especially in those dried-out human cadavers, but if not that certainly 
in apes. In that account he fully indicates he has absolutely decided 
that everything is the same in apes and humans and that his descrip¬ 
tions at least fit apes if not humans. I shall accordingly set the bones 
aside and deal with what has now been propounded about a number 
of differences in other parts of the body. 

Conclusions drawn about the fat, muscles, and ligaments, 
whereby it is concluded that Galen did not describe 
the human fabric 

Here a large distinction between the ape and man immediately comes 
to mind in the arrangement of fat, which accumulates in man as in 
the pig in large quantities between the skin and the membrane that 
covers the entire body like a skin among the other membranes of the 
body and is commonly called fleshy. The thickness of this fat, which 
easily exceeds the width of a palm especially around the buttocks in 
women of good appearance, varies considerably both in the regions 
of one body and in the bodies of the obese and those consumed by 
wasting. I have not seen any body to have so wasted away that I did 
not still find some fat and some familiar substance like a glandular 
and fibrous fat. Today, however, I know that nobody is so slightly 
trained in human dissections that he has not observed a quantity and 
thickness of fat between the skin and the aforementioned membrane; 
he will also have dissected either apes or dogs, or been present at the 
butcher’s when cattle, goats, or sheep are skinned or when hunters 
56 skin deer or hares; without doubt he has not failed to see that there 
is no fat ever in these animals between the skin and the fleshy mem¬ 
brane, and without the intervention of fat the membrane is coter¬ 
minous with the skin. Since this is so, where, I ask, in his anatomical 


books does Galen mention the fat which we see in such quantity 
beneath human skin? 

Though perhaps one may have decided to argue that that mass 
was not unknown to Galen because he made no mention of it, we must 
listen to what Galen himself said often, especially in the third book 
of De anatomicis administrationibus where he explains at length the arti¬ 
fice by which the nerves and veins running between the skin and the 
fleshy membrane should be examined. There he carefully sets forth the 
technique for inserting a knife in such a way that you do not damage 
the membrane along with the skin and do not remove both together 
from the underlying parts as butchers do. 76 In the simian or the dog it 
is no easy task, as he writes there and in the first book of De anatomicis 
administrationibus, to do this skillfully, and he was right with respect to 
simians. But no one is so witless that he would remove the skin along 
with the fat and the membrane in a human instead of the skin by itself. 
Neither in man nor in the pig does one need to be warned so much not 
to damage the skin with the membrane on the arms and legs, and much 
less still on the chest, abdomen, and the sides of the thorax when the 
skin alone is to be removed from it. But it is clearer than day that Galen 
spoke rightly about his simians and dogs and bypassed the construction 
of man in that part. This is to say nothing of the crowds that are stirred 
up in the schools when it happens that there is a silly dispute about the 
fleshy membrane because people navigating from books alone' assert 
with Galen that this membrane is next to the skin and that the fat in 
man lies underneath the membrane: those who have not come to that 
point of stupidity argue that all of the abdominal muscles together he 

76 See De anat. admin. 2.348.4, where Galen instructs dissectors of the hand to remove 
the skin but not “the membrane beneath, through which the nutrient veins reach 
it.” (tr. Singer 1956, 63).Vesalius is referring to his criticism of Galen in Book II ch. 5 
of the Fabrica in the section where he describes the “fleshy rag” or panniculus carnosus 
of the abdomen, part of the fleshy membrane or fascia that in humans is separated 
from the skin by a layer of fat. 

77 Vesalius used this metaphor three times in the Fabrica. The metaphor of navigating 
a ship at sea by nothing more than a manual is from an adage cited by Galen, who 


under the membrane, or as is read in the translators of the Arabs, they 
have the muscles instead of the fleshy rag. 

I believe you still remember how many trifles the pannicu- 
lus carnosus of Mondino 78 stirs up in the schools. To this should be 
added the difference between man, ape, and dog regarding the fleshy 
membrane occurring at the sides of the thorax. In those animals the 
membrane there is nourished by fleshy fibers and is made so muscular 
that Galen makes a special muscle of it, responsible for motions of the 
upper arm. But man has nothing in that part in common with cattle, 
sheep, and the animals just mentioned. It should therefore not appear 
surprising that I say man does not have this muscle, although with 
Galen I observe that fleshy place in simians and dogs. 

For the same reason, I find in caudate apes the muscle that Galen 
said passes upward from the area of the breasts to the joint of the 
humerus and moves the arm to the false ribs, and I give a lengthy 
account of it in my book to elucidate certain passages in Galen. But 
since it does not occur in humans, it is another reason why I pretend 
not to notice that Galen dissected apes, not people. 79 

Like that muscle is the one 811 that takes a fleshy beginning in apes 
from the occipital bone, and with a width equal to its beginning like 
a muscle that is not too wide descends all fleshy the whole distance 
obliquely somewhat forward until it reaches the upper angle of the 
base of the scapula and as it ends here in a wide tendon is inserted 

compared the study of anatomy from anatomical books to navigation out of a book. 
See Galen De compositione medicamentorum per genera 13.605.1—4. 

78 Mondino de’ Liuzzi (c. 1270—1326), professor of medicine at Bologna and author of 
the influential Anatomia (ca. 1316) which was the standard manual of dissection for 
two centuries and the subject of a much longer 1521 commentary by Berengario 
da Carpi. 

79 See the section titled “The muscle adducting the arm to the chest, which is promi¬ 
nent in the ape” in chapter 23 of Bk. II of the Fabrica. 

80 See the section titled “The muscle raising the scapula that is found in the ape” in the 
same chapter of the Fabrica. It is probably the m. rhomboideus, pars capitis, not found in 
man, described in Galen’s De anat. adm. 2.450.7ff. (Singer 1956, 107). 


there on the inner surface of the scapula where we have established in 
its dorsal side the base of its spine. That is much different than in man, 
who lacks that muscle altogether, no less than he lacks another 81 that 
is elegantly viewed in simians by Galen, that originates with a fleshy 
beginning from the transverse process of the first cervical vertebra 
and then from the transverse processes of the third and fourth verte¬ 
brae, and becomes wider than the aforesaid muscle; he wrote that it 
is inserted into the scapular spine at the point where it produces the 
acromion, and is established as if directly opposite the neck of the 
scapula. I do not miss this muscle in simians, but I know very well 
that humans do not have it. 

I would also like it to be noted that a muscle common to sim¬ 
ians and humans, which also arises from the transverse processes of 
the upper cervical vertebrae and is inserted in the upper angle of the 
base of the scapula, is stronger and larger in man than in simians. 82 It 
should not go unmentioned here at what length Galen describes the 
upper part of this muscle 83 and nearly forgets himself arguing about it 
with Lycus; I usually compare it to the hoods of monks and call it the 
second of the muscles moving the scapula. But after describing many 
muscles, Galen devotes scarcely a word to the lower part of this mus¬ 
cle. One should contrary to the usual opinion be convinced by this 
that the muscle was not dissected in humans but rather in dogs. 

In addition, Galen never saw the muscle in man that he said in 
two places takes its beginning from the hyoid bone and is implanted 
in the scapula, and that the scapula is raised by it (he was deluded in 


81 See the section titled “A fourth muscle which apes have but humans do not” in the 
aforementioned chapter of the Fabrica. It may be identified as the simian m. atlan- 
toscapularis anterior which Galen mentions in De anat. adm.2A69.2fE. (Singer 1956, 
pp. 116f.) 

82 See the section headed “Third of the muscles moving the human scapula” in 
chapter 26 of the second book of the Fabrica. This is the m. levator scapulae. 

83 Vesalius is now talking about the trapezius, described in the section of Bk. II ch. 26 
entitled “Second of the muscles moving the scapula.” Galen’s description is in De 
anat. adm.; The passage cited by Vesalius is in the sixth chapter of Bk. 4 (2.449.3ff., 



the function of that muscle ); 84 otherwise he would not have writ¬ 
ten that it is fleshy throughout its course, as can be seen in simians. 
He also would not have said that no muscle whatever in the entire 
body looks like the one 85 to which we say the function is entrusted 
of drawing the lower maxilla downward: it is formed as if with two 
bellies and becomes tendinous halfway in its course, taking the shape 
of a rounded tendon. Like the muscle from the scapula inserted in the 
hyoid bone, it appears sinewy in man where it enters the muscle that 
originates from the clavicle and the sternum and is implanted in the 
occipital bone, serving motions of the head. 

This muscle that we happened to mention shows that Galen 
by no means dissected muscles moving the head in man, as will 
be obvious to anyone who has compared a caudate ape with man 
here and has learned to apply Galen’s description, which is more 
accurate in different places, unlike this one, to the ape. There, the 
origins of the aforementioned muscle are more distinct than in man, 
and another muscle is extended to it and attached to it first at its inser¬ 
tion much differently than we (together with the anatomists who pre¬ 
ceded Galen) discovered in man: we determined a single muscle here, 
though in apes it would easily be possible to increase the number. 

What I now have to say, however, will demonstrate more clearly 
still that the second pair of muscles moving the head , 86 as their 

Singer 1956, 107) where Lycus is criticized for saying that the trapezius draws the 
head to the shoulder rather than the opposite. 

84 Vesalius makes this argument in Fabrica Bk. II ch. 17 in the section headed “The 
fourth pair [of hyoid muscles] does not assist motions of the scapulae.” In Book 13 
of De usu partium Galen had written “the slender muscle [m. omohyoideus] arising 
from the lambdoidal [hyoid] bone draws [the scapula] forward; for this muscle too 
is inserted into the bone of the shoulder blade near the acromium.” (4.140.4—7, tr. 
May 1968, 618). He made a similar statement in Book 7: “the muscles that extend 
[from the hyoid bone] to the shoulder blades give them a motion toward the neck.” 
(3.592.18-593-1, tr. May 1968, 375 and n. 69). 

85 The digastric muscle. 

86 These are described in Bk. II ch. 28 of the Fabrica in the section titled “The second 
pair is quite various.” 


description in Galen argues so clearly, is the one he dissected in the 
dog and the ape, since it matches those animals but by no means 
man. In that pair he shows so many muscles that are quite different in 
form, in many bellies, tendons, and multiple ways of coming together, 
whose description he cannot accomplish except in a lengthy account, 
from which it will be possible to refrain because I believe it is all too 
clear to people who undertake an anatomy that the muscles moving 
the human head were not taken into consideration by Galen. 

Again, if we have noticed that the human thorax is shorter than 
the thorax of quadrupeds, 
it will be no surprise that 
a different set of muscles 
moving the thorax is found 
in dogs and caudate apes 
than in humans, and beyond 
doubt it is from this that 
the strength of my proof is 
evident. Galen counts the 
muscle extending along the 

Detail of the fifth ecorche in 
the series at the beginning of 
Book 5 of the Fabrica, showing 
the upward continuation of the 
rectus abdominis (r to t) as it 
would appear, say, in the dog. 

anterior part of the thorax, which I find in dogs and caudate apes, as 
part of the rectus abdominis muscle. For where this muscle ends above 
the rib cartilages in humans, at that point in those animals it puts forth 
a kind of long tendon extended along the rib cartilages beside the 
sternum and next to the cartilage of the second rib, augmented by a 
fleshy protuberance like a flat stomach muscle. Because none of this 


appears in man I cannot deny faith in my eyes and ascribe the muscle 
to man solely on the authority of Galen . 87 ^ 

60 So I do not attribute to man the muscle [m. scalenus longus] that 

was directly apparent to Galen as it is to me in dogs and simians, 
taking its beginning from several transverse processes of the cervical 
vertebrae and serving motions of the upper ribs; it runs along the 
anterior surface of the muscle [m. serratus anterior] that originates from 
the scapula and is inserted like a hand on the eight upper ribs. I count 
the latter the second of the muscles moving the thorax. 

I know that I have made my account of the lumbar fleshes (to 
use the word of other anatomists) quite different from Galen’s, and 
that a large difference presents itself here between man and the apes; 
but because Galen’s descriptions in this place have seemed to me quite 
mixed up and difficult, but do not everywhere accord with dogs and 
apes, I can take no argument for myself by which it may be proved 
that Galen did not dissect humans . 88 However, no one can be in doubt 
that Galen’s descriptions have been matched to dogs much more than 
humans, particularly because of the muscle of which they have so 
much. Similarly, in the account of the ligaments of the spine you will 
notice that human ligaments were not dissected by Galen — or any of 
those that he says extend along the length of the back to the vertebral 

87 This muscle is described in Fabrica II ch. 35 in the section titled “The fifth muscle in 
dogs, missing in the human thorax.” It is illustrated inVesalius’ Fifth Table of Muscles 
as if it existed in man.The 1555 edition of the Fabrica adds to the figure legend “The 
wide tendon and this fleshy part are the muscle that Galen counts the fifth of those 
moving the thorax, but it is not to be seen in humans as it is in caudate apes and 
dogs. We have nevertheless drawn it here so that Galen can be understood, because 
elsewhere this part of the chest would be like the chests in the next two tables, with¬ 
out these muscles.” 

88 Vesalius refers here to his remarks in ch. 38 of Bk. II of the Fabrica in the section titled 
“Ninth and tenth” [of the muscles moving the back]:“How clearly and truthfully Galen 
described these muscles or fleshes of the loins (to use the translators word), and whether 
his account fits the ape or dog (which differs considerably from man in the muscles here) 
will be for you to judge. It does not quite square with the ape, much less with man, as 
you will understand perfectly (if you are a student of Galen, as surely we all should be) 
when you perform some dissections and compare what we say with his oracles.” 


spines; they are never found in humans as they are in cattle and sheep, 
unless you have the best reason for finding them. 

If we have observed the tendon [m.palmaris longus, tendo ] 89 hidden 
in the hand, we would not dare to assert that it extends everywhere 
beneath the hairless skin of the hand since the fleshy mass occupying 
the first joint of the thumb known as the Venus mount by palm read¬ 
ers, and the mass that stands at the outer side of the palm below the 
little finger which they refer to as the Moon, and likewise the sides 
of the fingers, are not covered by that tendon. However, when we 
study the hand of the simian and observe a hairless region there, the 
account in Galen is understood to be more consonant with the truth. 

It is not unlike what Galen stated when he was more experienced in 
dissections and did not so much invent the fabric of the body and 61 
write from the opinions of others or his own imagination, that the 
tendon to which is entrusted the task of flexing the third joint of the 
thumb is thinner than those that flex the third joints of the remaining 
fingers.That is because we see that a more or less special muscle in man 
puts forth an extremely strong tendon to the third bone of the thumb; 
this muscle is not at all inferior to the others that go to the third bone 
of the fingers. But it is not strange that such an idea was passed on to 
posterity by Galen, since we know that the simian thumb is much 
inferior to the human thumb in both strength and size, and should 
therefore be content with a thinner muscle. That he made his exami¬ 
nation of this muscle and its tendon in non-caudate simians, I gather 
from the following: that in caudate simians and others that have a small, 
weak thumb, this muscle would be missing, and its functions would be 
performed by a portion of the small tendon that flexes the third bone 
of their middle finger. From the middle of the palm, a small portion 
of tendon originates from the tendon that branches transversely to the 
thumb. I think that Galen would at some time have seen something 

89 Vesalius devoted all of Bk. II ch. 41 to the palmaris longus and its tendon, and 
refuted Galen’s description of the tendon in De anat. adm. and De usu partium. 



like that, since in De usu partium he ignored the five muscles that cause 
flexion of the first and second bones of the thumb and wished to 
make up a reason why he would show that the thumb is flexed over 
the remaining fingers toward the middle of the palm. He stated that a 
certain muscle was divided into five tendons before it passed through 
the wrist, four of which made three equal angles and went to the four 
fingers; the fifth tendon, along with the one that goes to the middle 
finger, was gathered together and taken to the middle of the palm, and 
from there, like the rein with which a charioteer drives a horse, it was 
extended from a ring transversely to the thumb .'" 1 

But now it is not my wish to run through any of the false 
descriptions, contradictory opinions, or an action or function 
unknown to Galen, but only those things that force me to say he did 
not dissect a human. 

To this category also belong the muscles that extend the fore¬ 
arm, which Galen described in the first book of De anatomicis admin- 
istmtionibus (in De usu partium everything about the muscles moving 
the forearm is absurdly fictitious) as they are in the ape. It is there¬ 
fore no surprise that he counted three muscles among the extensors 
(unlike what we see in man ). 91 While one originates in man from 
the humerus and another from the lower rib of the scapula, both are 
joined and come together before the mid-length of the humerus as 
if the beginnings should be thought of as belonging to a single mus¬ 
cle. Then, since I wrote that the beginning that originates from the 
humerus grows in its fleshy portion as it descends, it becomes quite 

90 These remarks summarize and extend criticisms of Galen made in ch. 43 of Bk. II 
of the Fabrica, on the finger muscles. See especially the section titled “Many things 
are set forth here contrary to the views of Galen.” 

91 The 1543 Fabrica did in fact identify the three extensors of the forearm that mod¬ 
ern anatomy counts as a single muscle, the triceps brachii, but he changed his mind in 
the 1555 Fabrica. See n. 12 in my edition of Fabrica Bk. II, Second Table of Muscles, 
where O is the caput laterale and P is the caput longum. In the legend for Q he men¬ 
tions the caput mediale as the third muscle, but changes that to second in the 1555 
edition. The same change is made at X in the 12th Table of Muscles. 


difficult to consider it as a separate muscle. But apes have three distinct 
muscles, and Galen’s inconsistent accounts show no muscles except 
for a single quite thin muscle that I have said in my book is borne 
from the scapula to the ulna in caudate apes. 

I do not remember clearly whether the beginning of the ante¬ 
rior of the muscles flexing the forearm [m. biceps brachii], which arises 
from the inner process of the scapula, is more slender in simians than 
the one that takes its origin from the top of the neck of the scap¬ 
ula, as Galen liked it . 92 However, in man it appears quite different, as 
the inner beginning is quite wide, partly sinewy and in part fleshy, 
while its outer beginning resembles only a rounded tendon. Similarly, 
the inner origin is also sinewy perhaps only in simians, presenting the 
appearance of a tendon because the inner process of the scapula is 
extended less in them than in humans. For this reason Galen is seen 
to be more readily deceived in that muscle, which because it performs 
only motions of the scapula he wrongly made the adductor of the upper 
arm to the chest. In simians, this muscle at its insertion faces somewhat 
into the ligament of the joint of the scapula with the humerus, since O ' 
it was able to make such a small insertion into the inner process of the 
scapula (differently than in man); the complete insertion extends into 
the otherwise large inner process of the scapula . 93 

The first of the muscles moving the tibia [m. sartorius] origi¬ 
nates from the anterior side of the epiphysis of the iliac bone and 
is taken on an oblique path ultimately to the tibia; in humans it is 
inserted by a round tendon, but in simians, as Galen also testifies, by 

92 Vesalius faults Galen’s description of the muscles of the upper arm in the section of 
Bk. II ch. 23 titled “The muscle adducting the arm to the chest, which is prominent 
in the ape.” 

93 This critique of Galen goes beyond any found in the Fabrica (Bk. II ch. 46 on the 
flexors and extensors of the radius), where Vesalius had written “I shall reveal all of 
this in my annotations to the Anatomical Works of Galen, which I have already well 
begun and shall at some time publish separately or together with the books of Galen 
much better corrected than formerly.” 


a wider tendon . 94 However, it is clear not from this muscle alone but 
from many other movers of the tibia that Galen left posterity with a 
description of the muscles in simians, since he ascribes width to all 
the tendons inserted on the front of the tibia (as we definitely see in 
simians) while in man they are rounded and more compact. This dif¬ 
ference is seen to be more pronounced in dissections than one would 
believe from books alone. Now too a muscle quite familiar to Galen, 
and called wide by him, shows no less a distinction; we call it the 
fourth of the muscles moving the tibia [m. biceps femoris, caput longum], 
and it has an appearance in man far different from that in the simian. 
This fourth muscle in the simian issues from the lowest surface of the 
hip bone, as Galen rightly said (though he errs in telling the series 
and order of heads originating therefrom) with a strong beginning, 
which early in its progress forms a larger, wide muscle that is sim¬ 
ple throughout its course, moving along the outer head of the femur 
to the tibia and the seat of its insertion there. In man, however, the 
beginning of the fourth muscle is entirely sinewy, and a little beneath 
its origin it first becomes fleshy, presenting the shape of a completely 
formed muscle in the form of a mouse or lizard, but not of a wide 
muscle. When it has more or less passed the halfway point down the 
femur it becomes thinner and appears notably sinewy on its outer 
side, being about to end in a tendon. But on its inner side, where it 
64 still preserves the nature of flesh, a fleshy portion [m. biceps femoris, 
caput breve] to which the femur provides a beginning attaches to it just 
as if a pecuhar muscle were increasing it and both together make up 
a thickened muscle which is eventually very strongly inserted in the 
apex of the fibula. 

A portion of the muscle identified as the fifth of the muscles 
moving the femur [m. adductor magnus] which is implanted in man 

94 In Fabrica Bk. II ch. 53 Vesalius called attention to this error in Galen. A marginal 
note (p. 331, misnumbered 231) cites Bk. 2 of De anatomicis administrationibus, where 
Galen called the tendon of the sartorius muscle “a flat tendon, somewhat fleshy,” 
tevcov ttAcctus pp£(ja aapKco5r)s, (2.293.13 £, tr. Singer 1956,37). 


by a round tendon into the inner head of the femur, makes a fleshy 
insertion in simians. It is therefore no surprise that Galen puts it in his 
writings no differently than if it were the same in man as well . 95 

More or less similar to this place is the difference observed in 
the tendon [aponeurosis plantaris] hidden under the sole of the foot. 
In simians, we are able to see the muscle that originates in the outer 
head of the femur; after it has reached halfway down the tibia it ends 
in a thin tendon that is carried through its own groove carved in the 
back of the heel bone and enters the sole, hiding there as is seen in 
the hand. In the opinions of Galen, the ape is the same in this part, 
except that no portion of this tendon is implanted in the heel bone; 
rather, it is slightly linked to the heel by means of the transverse lig¬ 
ament. Galen, however, taught that this tendon is split in two, with 
one portion attached to the heel bone while the other enters the sole 
of the foot. In man, on the other hand, we do not detect the muscle 
brought out into the hidden tendon, though we do not miss the liga¬ 
ment growing on the muscle [m. flexor digitorum brevis ] that we name 
the flexor of the second bone of each of the four toes. It is perfectly 
clear that it performs the functions of such a tendon from the fact 
that the muscle split into four tendons before they enter the trans¬ 
verse ligaments of the toes no longer bears that ligament attached to 
it. But as it leaves the muscle there, it is separated into five processes 
spread out in the lower region of the five digits of the foot. It is not 
possible that anyone would believe that the muscle I have named the 
third of those moving the foot [m. plantaris] is applicable to Galen’s 
account, since before it has passed a noteworthy distance beyond 
the knee joint it ceases to be fleshy and is attached to the inside of the 
heel at about the middle of the distance one could measure from the 
tibia to the end of the heel. Moreover, it is not so great a task for that 


95 The portion of the adductor magnus described here is the hamstring portion, which 
inserts into the adductor tubercle of the femur. This criticism of Galen is another 
not found in the Fabrica, and could therefore be one of the comments Vesalius had 
intended for his projected edition of Galen. See n. 93 above. 

7 5 

ligament to be compared to the aforementioned ligament peculiar 
to humans . 96 

At this time the tendon of the first two muscles moving the foot 
[m. gastrocnemius, caput mediate and caput laterale] should be carefully 
examined. These originate from the heads of the femur and create 
the more protuberant region of the calf; they end together below the 
middle of the tibia in a strong, wide tendon that runs downward in 
caudate apes and as it becomes gradually narrower is attached to no 
muscle; it is inserted unmixed into the heel bone, as Galen’s account 
nicely explains. It is much different in humans,' in whom the tendon 
passes far beyond the heel bone, joins completely with the tendon of 
the fourth muscle moving the foot [m. soleus ] (which also forms the 
calf together with the two muscles just mentioned), and is so attached 
that you could scarcely separate it in one piece as far as the heel bone. 

To this distinction is added the one that a person would rightly 
judge worth considering in the tendon of the fourth muscle just men¬ 
tioned. Galen contends that this muscle, originating from the tibia and 
the fibula, does not end in a complete, fleshless tendon, but makes its 
insertion still fleshy in the heel bone. This is how that muscle is inserted 
in simians, as I know. But it is otherwise in man: for a long interval 
before this muscle is inserted in the heel, it ends in a perfect tendon that 
in no way resembles the nature of flesh; increased by the tendon of the 
first two muscles, it goes to the heel. Homer was certainly not ignorant 
of this when he describes the course of the rope by which Hector, tied 
to the chariot of Achilles, was dragged around the walls of Troy .’ 6 

We should also not pass over here the visually elegant diffe¬ 
rence between the muscles that lie beneath those just mentioned in 

96 The antecedent to this paragraph is chapter 58 of Bk. II of the Fabrica, “On the 
Hidden Tendon Attached to the Skin on the Sole of the Foot.” 

97 This distinction is explained at the beginning of ch. 59 of Fabrica II. 

98 “In both of his feet at the back he made holes by the tendons in the space between 
ankle and heel, and drew thongs of ox-hide through them, and fastened them to the 
chariot so as to let the head drag, etc.” Iliad 22.396 ff., tr. Lattimore.This episode was 
also cited in Fabrica II ch. 59. 


the posterior region of the tibia, two of which are responsible for 
motions of the toes. I count them the second [m. flexor hallucis longus] 
and third [m. flexor digitomm longus] of the muscles moving the toes; the 
one covered by those two, lying closest to the tibia and fibula, is con¬ 
sidered the fifth [m. tibialis posterior] of those that move the foot. Before 
they reach the lower epiphysis of the tibia, these muscles in simians 
are stripped of their fleshy substance and like other muscles that have 
round tendons they end in a tendon. But in man they have a peculiar 
form; when they are about to put forth the tendon they appear about 
as wide as in the middle of their course, and they put forth a tendon 
from only one side while the angle of the other side is still fleshy as if 
it were to be regarded as the angle of a fleshy quadrangle." 

Still more relevant to the present topic is the difference in man of 
the sixth muscle moving the foot [m. tibialis anterior], which is at vari¬ 
ance with the construction of the ape and conflicts with the descrip¬ 
tions of Galen. 10 " In man, the muscle in front of the tibia standing 
ahead of all the others in this region takes its beginning where the 
fibula is joined to the tibia and resembles an elegant type of muscle; 
below the middle of the tibia it ends in a round tendon that is carried 
by the transverse ligament at the front of the tibia next to its joint with 
the talus and ends in the metatarsal bone that supports the big toe. In 
caudate apes, however, that tendon not only becomes two-horned 
to look like the eighth muscle moving the foot [m. fibularis brevis], 
which is brought down along the lower epiphysis of the fibula in the 
transverse ligament and inserted in the metatarsal bone that supports 
the little toe — not only that, in caudate apes two quite conspicuous 
muscles appear to dissectors, of which the posterior is much thinner 
than the anterior and is laid over it: both are implanted in the bone 
that I said admits the sixth human muscle. 

99 This observation is independent of anything said in Fabrica II ch. 60 on the muscles 
moving the toes. 

100 This criticism of Galen does not appear in either edition of the Fabrica. 


The muscle that causes flexion of the second joint of each of 
the four toes [m. flexor digitorum brevis] differs in man as much from 
the ape as the hidden tendon with the ligament attached to that 
muscle, except that it is conspicuous for longer tendons in apes to the 
degree that their foot is longer than the human. 101 It should not seem 
strange that we ascribe a longer foot to the ape than to man: Galen 

shows in a long account that it is 
the longest of all. But how truly 

Detail from fig. 14 in Bk. II of the 
Fabrica, showing various flexor mus¬ 
cles in the sole of the foot. A marks a 
segment of the flexor hallucis longus, 
Vesalius’ second of the muscles mov¬ 
ing the toes; 2 is the flexor digitorum 
longus, Vesalius’ third of the muscles 
moving the toes; k marks the tibialis 
posterior, Vesalius’ fifth muscle mov¬ 
ing the toes. 0 is the flexor digitorum 
brevis; on the right it has been severed 
from its origin and hangs from its sev¬ 
eral insertions. 

he says this is easily known to anyone who pays close attention and is 
warned by me of a contrary view. Now the big toe on the simian foot 
is different from ours, as is the different separation of the toes, which 
Galen did not fail to mention in his books since he knew it without 
dissection; these also should have taught him that there is a much 
different construction of the muscles moving the toes in humans 
than in apes. For although he is forgetful of himself in describing 
those things, you will nevertheless say that the opinion closest to the 


See Fabrica II ch. 60, the section titled “How the first, second, and third muscles are 
arranged in the apes.” 

truth is no doubt the one which most closely agrees with simians in 
large numbers differing from humans. Lest I pass over all the tendons 
moving the toes, I think the tendons of the second and third muscles 
that move them are worth considering. Previously, I have told how 
the muscles that occupy the back of the tibia put forth their tendons 
differently in humans than in simians; the series to which they belong 
must now be examined. The tendon of the second muscle in man 
moves obliquely through the bottom of the foot and goes chiefly to 
the big toe, inserted very strongly in its second joint. The tendon of 
the third muscle is carried obliquely beneath it crosswise toward the 
ground, or is situated with it like an X.Taking on a tiny portion from 
the tendon of the second, and slightly increased by it, it is divided 
into four tendons going to the four toes, creating flexion of their 
third bone. These are as much thinner than the one that goes to the 
big toe as the big toe surpasses the others in thickness and bulk. In 
caudate apes, where the tendon of the second muscle goes crosswise 
with the tendon of the third, the entire tendon of the second 
muscle is altogether blended with the tendon of the third and joins 
with it, and so there is one tendon out of two. The tendon result¬ 
ing from that juncture puts forth a slender tendon or small portion 
transversely to the big toe to flex the bone to which the toenail is 
attached, just as in the palm of the caudate ape I was saying that the 
tendon flexing the third bone of the middle finger gives off a small 
portion transversely to the thumb of the hand. The principal portion 
of that blending is separated into four tendons and extended to the 
other toes; these tendons are much thicker than the small portion 
going to the big toe. It should not be surprising that the different 
construction of the big toe creates many differences in the muscles, 
such as the one arising from the muscle that comes separately from 
the metatarsal bone supporting the second toe, is inserted in the big 
toe of the ape, and adducts it closest to the second toe. 

Similar to that is another series belonging to the fleshy mass 
[mm. extensor hallucis brevis et extensor digitomm brevis ] in man located in 



the upper part of the foot: it supplies one tendon to the big toe and 
the three toes closest to it, inclining them with the toe to the outside. 
In the simian big toe as in its hand there were two muscles implanted 
in its upper side, the thinner of which is employed in the function of 
the tendon that I was just now saying goes to it from the upper side 
of the foot. Then two quite confined muscles occupy the upper side 
of the foot, by which the four toes are abducted from the big toe (as 
Galen rightly wrote). Thus the muscles flexing the first joints of the 
toes in the human foot cannot so easily be summed up in a number 
and appear more like an inseparable fleshy mass than in simians, in 
whom they exhibit a more elegant arrangement, as they do in the 
muscles of their hands. 102 

But why does it seem strange that so many differences present 
themselves in great numbers in the muscles of the foot, when we 
observe a great difference in their motions and never discover the 
same construction in a variety of operations, actions, or functions? 
Let it suffice, therefore, that I have cited these places from the study of 
the muscles and ligaments in which I demonstrate that Galen did not 
dissect a human. 

Several places taken from the series of veins and arteries 
in which it is inferred that Galen did not dissect 

It likewise happens in the veins and arteries that I think no one’s 
authority will have the same weight as his argument. For if Galen, 
when about to write the book De venarum artenarumque natura about 
the veins and arteries and the system by which they are distributed 
through the entire body, openly warns Antisthenes that he is going 
to write out as notes the facts about veins and arteries which he 

102 This complexity, as opposed to the simplicity described by Galen, is explained 
in Fabrica II ch. 60 in the section titled “A muscle situated in the top of the foot, 
abducting the big toe and the three next to it to the outside, numbered 16.” 


had himself seen in apes, with no mention made of man, 103 what 
conclusion are we to draw except that the course and distribution of 
the veins and arteries of apes is described by Galen? — the more so, as 
I believe that in none of the books of Galen does he himself mention 
any difference in which he was aware that apes differ from man in the 
branches of the vessels? You could perhaps make an exception of his 
tenth commentary on Hippocrates’ On Regimen in Acute Diseases, on 
the occasion that I shall soon describe where he imagines contrary to 
the truth of the matter that the human azygos vein takes its beginning 
from the vena cava, unlike that of apes. As soon as I have set forth cer¬ 
tain noteworthy differences out of many in which man varies from 
the ape and the dog in the distribution and course of the vessels, I shall 
add something about the azygos vein. 

If we consider that throughout its course where it extends 
beneath the stomach or where it runs from the site of the spleen to 
a point beneath the liver, the large intestine has no part of the mes¬ 
entery in humans, but lies entirely beneath what we call the lower 
membrane of the omentum in the posterior side of the stomach run¬ 
ning from the spleen to the liver instead of in the mesentery itself, 
it is established that it is different from what it is in simians and still 
more so from what it is in dogs. It will soon also be clear that the 
series of branches of the portal vein is different in man than in the 
simian. For from the trunk of the portal vein, which is supported by 
the lower membrane of the omentum and extends along the main 
portion of the spleen, large veins are woven into the large intestine of 

103 In Fabrica III ch. 5 when describing the distribution of the left trunk of the por- 
tal vein Vesalius wrote “it is no surprise if I sometimes depart from Galen’s views 
in this part of my account. He openly writes about the veins of monkeys, as he 
himself wrote to Antisthenes, and does not deal with the veins of humans.” A mar¬ 
ginal note refers to Galen’s work De venarum arteriarumque dissectione, at the begin¬ 
ning of which he tells his contemporary Antisthenes of Rhodes that his synopsis 
of veins and arteries is based upon the body of the monkey. Vesalius had edited 
Antonio Fortolo’s Latin translation of this book for the 1541—42 Giunta edition: 
see Cushing 1962, 66; O’Malley 1964, 106. 


man throughout the section just described, which it is no surprise that 
Galen did [not] describe, since he handed on to posterity a descrip¬ 
tion of simians and dogs rather than of humans. 

I will not discuss how two veins interweave the fundus of the 
stomach in humans and attach to the upper membrane of the omen¬ 
tum; one of these enters the stomach from the right side, the other 
from the left. Both end at the middle of the stomach. However, in 
dogs a single vein going to the stomach from the left side, which runs 
along its entire fundus as far as its lower orifice, is inserted from the 
lowest vein of the spleen. 

Similar to this difference is the one that arises from the large 
series of other offshoots growing from other veins that are now close 
to the spleen and are disseminated throughout its body.Though Galen 
does not mention more than two offshoots, they are definitely many 
and various in the human spleen at its connection to the stomach. 

But I did not propose to mention here everything available that 
is scattered in the books of my De hutnani corporefabrica, since it would 
suffice to mention something about most of the organs individually. It 
will therefore be fitting that I have already mentioned the vena cava, 
which principally will show (if it does nothing else) that Galen never 
saw a human dissection, or what one would easily have noticed from 
the course of the vena cava through the transverse septum. As the dog 
and the ape greatly surpass man in the length of the thorax, so too 
the course of the vena cava through the thorax is deservedly differ¬ 
ent for man and for an ape. 104 And so the vena cava of the simian or 
dog passes through the transverse septum and enters the cavity visi¬ 
ble between the two membranes separating the thorax and between 
the wrapping of the heart and the transverse septum where there is 
a peculiar lobe or fiber of the lung supporting the vena cava like an 
extremely soft bed, holding it up more or less like a hand in this long 

104 ■phis the subject of a section in Fabrica III ch. 7 titled “Features that do not at this 
point agree with Galen’s views.” 


passage in which it is otherwise suspended and carried by no body, 
not without the unique design of Nature. From this space, the vena 
cava is contained in this way by the lung and passes through the wrap¬ 
ping of the heart, finally opening into the heart via an orifice much 
larger than its own stem. 

Furthermore, the wrapping of the heart in man is attached to the 
septum by its entire lower surface of considerable size, and no interval 
presents itself between the wrapping of the heart and the septum, in 
which there could be a cavity between itself and the membranes that 
divide up the thorax. So too there was much less reason why a peculiar 
lobe of the lung needed to be placed here to support the vena cava. 
Therefore the vena cava passes through the transverse septum together 
with the wrapping of the heart without the aid of any empty space or 
any body, for this reason differing in many ways from the course of the 
vena cava in apes and dogs, a distinction not noticed by Galen as he did 
state a difference in the beginning of the azygos vein. It is the only one, 
as I recall, among all that one could count beneath the skin in dissec¬ 
tions. It should therefore by considered with exact diligence by those 
who argue that Galen dissected humans, even after being warned, so 
that those who perceive no difference there should not be in a hurry 
to set aside their own reason because of piety toward Galen. 

It is a precept of Hippocrates that when pain in the side reaches 
as far as the clavicle, the inner vein of the forearm should be opened; 
but when the pain stands lower down, even below the septum, a pur¬ 
ging medication should be administered. 1 " 1 Galen understood this 
precept just as if Hippocrates had recommended bloodletting in 
tumors that affected the four upper ribs; but when in some cases the 
trouble lay in the eight lower ribs, a purgative drug should be admin¬ 
istered. It is no different than if Hippocrates had believed those ribs 



105 Vesalius’ statement here is anachronistic, coming from medieval venesection lore 
unattested in the Hippocratic writings, or attributed to Hippocrates by Galen or 
Pollux. For what the Hippocratics actually wrote about bloodletting, see Brain 


were too distant from the veins to be cut, or because he feared that 
the blood close to the inflammation would be taken through the heart 
whenever the brachial vein would be opened for inflammations of the 
lower ribs. This follows the reasoning on which we know Avicenna’s 
Canon was based, that we should not take poisonous blood through 
worthier parts, as if Hippocrates had prohibited veins in the forearm 
to be opened for inflammations of the liver, stomach, and spleen. You 
know that I have explained elsewhere how I understand the place in 
Hippocrates, and that I have also showed from the aforementioned 
opinion of Galen about that place that he believed that the divine 
Hippocrates, who was practiced in human dissections, had found a 
different series of veins in his apes than he had himself, which per¬ 
suaded Hippocrates to prefer a purgative drug to venesection. 

For that reason, Galen imagined a different origin for the azygos 
vein in humans than in apes, and because of the oracle of Hippocrates 
he became so agitated that he seems to have pursued quite contradic¬ 
tory thoughts about the beginning of the azygos vein. In his recently 
mentioned commentary on the second book of De victus ratione, 106 
Galen disagrees with himself three times. 10 When about to describe 
the system of the vena cava in the thorax, he states everywhere that 
the vein distributing offshoots to the eight lower ribs takes its begin¬ 
ning from the vena cava before it reaches the heart. After that, he 
writes that in some animals it originates from the vena cava above 
the heart, whereas in man he writes that it is put forth from the part 
of the vena cava where it reaches the right auricle of the heart. Then, 
unmindful of himself, he says a little later that the lower ribs of man 
are nourished by the vein that begins from the vena cava beneath the 
heart. This opinion resembles the one in Book Six of On the Opinions 
of Hippocrates and Plato where we are told that the wrapping of the 

106 Hippocrates’ On Regimen in Acute Diseases. Galen’s commentary on De victus ratione 
is In Hippocratis de victu acutorum commentaria. 

107 For these observations, cf. the section in Fabrica III ch. 7 titled “Galen’s views about 
the origin of the unpaired vein.” 


heart together with all the membranes partitioning the thorax and 
covering the lung take nourishment from the vena cava before this 
vessel is taken to the heart. I have no doubt that when he mentions 
the membranes surrounding the lung in that passage, he meant the 
membrane surrounding the ribs. But in his book On the Dissection of 
Veins and Arteries Galen stated that the azygos vein sets out from the 
right auricle for the left parts of the thorax and is taken to the fifth 
vertebra of the thorax in certain animals, while in simians he says it is 
placed a little above the auricle in the parts on the right. 

He says more here than in his annotations on De victus 
ratione, adding that the intervals between the ribs seek nour¬ 
ishment from the azygos vein. He expresses the same opin¬ 
ion in the seventh book of De anatomicis administrationibus, 
except he states simply that the vein takes its beginning here 
from the vein standing next to the right ventricle of the 
heart — though he adds wrongly that the azygos vein is taken 
there to the left parts of the thorax. 

At another point in his seventh book he teaches that 
this vein originates from the right ventricle of the heart, 

Two variations in the form of the azygos vein from Fabrica III 
ch. 1, where Vesalius wrote “In these two figures we have shown 
two arrays of the azygos vein that differ from the one shown in the 
complete illustration of the vena cava. Here, A marks the trunk of 
the azygos vein. B is its branch [v. hemiazygos] that runs to the left 
and is distributed into several offshoots. C in the lower figure shows 
part of the stem of the vena cava. ” 

just like the coronary, although this never happens in sim¬ 
ians. It is therefore all too clear that Galen believed that 
the azygos vein takes a different beginning in man and in 
simians. It is also no surprise that such different statements 
about this vein occur in his writings because he never 
examined the human vein. For him it originates in exactly 




the same way as it does in apes and dogs and corresponds to theirs 
in all ways — unless perhaps the human vein nurtures the upper ribs 
more than the vein in dogs. But we have observed that all the ribs 
are nourished by the azygos vein in humans and receive its offshoots. 
Although Galen had not examined the human, he was nevertheless 
compelled to look into the reasons why the azygos vein could not 
have taken its origin beneath the heart in humans, or even directly 
opposite the right auricle of the heart, and that no difference could 
be imagined here between the ape and man. For although Nature 
arranged for the stem of the vena cava to attach to the spine from 
the lumbar vertebrae to the upper vertebrae of the thorax, or for 
the offshoots from it at each node as in the loins, she was unable to 
present them to the intermediate vertebrae or the ribs; because the 
transverse septum, the liver, then the heart and the vessels distributed 
to the lung elevated the vena cava too far from the vertebrae and did 
not allow it to recline, it was necessary for her to lead off an offshoot 
like a trunk from the vena cava from which, while it was braced 
in its passage on the vertebral bodies, branches could be extended 
to all parts; because of the distance of the vena cava from the ver¬ 
tebrae it was difficult for these parts to receive twigs from it. Here 
Nature, as never elsewhere, did not miss the opportunity, but as soon 
as the vena cava passed the heart and traveled beyond its wrapping, 
both the processes of the great artery [aorta] alone and the trachea 
and the path delivering food and drink are prohibited from resting 
on the vertebrae and Nature brought out of the right side of the vena 
cava the large trunk that extends downward on the right side of the 
vertebrae and bestows branches on the ribs of both sides. We call it 
the unpaired vein [v. azygos] because another one paired to it, or a 
partner, does not originate from the vena cava. 

From the course that it takes along the right side of the verte¬ 
brae at the middle and impeded on its left by the great artery [aorta] 
and the passage that delivers food and drink, it is to be inferred that it 
could have taken its beginning neither from the left side of the vena 


cava nor from its lower side, and still less from its upper side. From this 
it is clear that it could not have been brought forth under the heart, 
for there was need for another vein to be presented to that interval 
of the back which is located between the origin of the former and 
the place where it now takes its origin. In such a case it would have 
hung too much and been braced too little if it had originated under 
the heart and been extended to the vertebrae, besides the fact that in 
man it would then have had to begin from the vena cava when it was 
still passing within the wrapping of the heart. That is a proof that the 
azygos vein does not begin from the vena cava directly opposite the 
right auricle, and here the arterial vein [tnmcus pulmonalis ] and the 
venous artery [vena pulmonalis ] would have been in its way, and then 
the branches of the trachea as they first separate into the lungs beneath 
the base of the heart. Because of them, it would have been necessary 
for it to climb too high before it could approach the spine, and it is 
only taking its beginning; or it would have had to pass too low and 
have gotten its beginning under the heart besides. 

Galen did not see the inner veins that hide deep in 
the human arm 108 

Here I would have made an end of sampling the proofs by which 
I am persuaded in the system of veins that Galen did not dissect 
humans, had not Sylvius, while making no mention of any other 
particular places, been specially offended to have read in my book that 
Galen saw only the outer and subcutaneous veins in man without 
dissection. To me this is as likely as it can be. I know that there is in 
no series of vessels as great a difference as there is in the veins run¬ 
ning under the skin of the forearm and the hand, so that we see few 
people who have exactly the same set of veins. But because I noticed 
that Galen’s description of this set of veins in the third book of De 


The background of the narrative that follows is in Fabrica III ch. 8 on the axillary 
and humeral veins. 

anatomicis administrationibus agreed most with the upper arms, at least 
in the course of the major branches, I easily concluded that those 

veins had been seen by him 
as we see them daily in vene¬ 
section. But I did not believe 
that Galen had seen the series 
of branches hiding deep in 
the body, since his descrip¬ 
tion does not for the most 
part agree with it. 

I will not mention that 
we have been wrong about 
the origin of the humeral 
vein, 109 which we thought 
originates from the jugular 
much higher than the axillary, 

Detail of the “Vein Man’’ pre¬ 
ceding Fabrica III Ch. 6. The 
humeral or cephalic vein is 
marked a; the axillary or basilic 
vein is m, r, and u. Greek a is the 
distal end of the median cubital 
vein (t) discussed below. 

to which the division of the vena cava in the throat gives its origin, and 
which is twisted in one way or another along the clavicle; because we 
trusted in books, we do not see that the humeral vein near the elbow 
joint in some way inserts a noteworthy branch more deeply, and with 

109 Vena humeraria, a Galenic vein: “The veins of the arm are two, the one running to it 
from the axilla and the one running along the clavicle which they call cibpicria.” (De 
venarum arteriarumque dissectione 2.792.2—4, tr. Goss 1961, 358, where it is identified 
as the cephalic vein). In humans the cephalic vein runs medial and anterior to the 
deltoid muscle, not lateral to the deltoid as shown in Vesalius’ illustration above. 


another branch of the axillary vein forms a vein \v. mediana cubiti] sim¬ 
ilar to it; this vein, made up below the skin from the two branches, we 
most correctly call the common vein. Others call it the middle vein. 
Although Galen writes that this meeting of veins occurs deep, he had 
earlier recorded that it is on the surface, not noticing that the axillary is 
divided into two trunks soon after its entry into the arm, and the one 
that runs more or less along the skin eventually becomes the one that 
Galen took for the whole axillary vein. But the larger trunk, distrib¬ 
uting significant offshoots here and there, joined throughout its entry 
with the artery to the arm and tucked between two muscles that flex 
the forearm, is borne into the forearm, making the same distribution 
as the artery (as I have written) as far as the ends of the fingers and not 
claiming anything in common with the humeral vein. In fact, you will 
find no small number, among which you will discover not even a trace 
of the humeral vein around the forearm, in that greater trunk of the 
axillary vein that I have described which readily presents branches to 
the skin, which Nature uses instead of the humeral. 

In addition, the idea must have moved Galen that the large veins 
must in every case have been distributed deep in the body to the 
radius, the ulna, and the hand, must have been much larger than the 
others, and must have preserved more of the same arrangement in all 
humans than the superficial veins scattered between the skin and the 
fleshy membrane. If this were so, how, I ask, could Nature have been 
so negligent that she took the vein \v. cephalica] under the skin through 
the length of the arm and on its outer side — the humeral vein itself, 
from which was then to be made half of the veins which were to be 
distributed to the forearm, to the bones of the hand, and in great num¬ 
ber to the muscles that surround them? Indeed, we could discuss the 
statement of Galen in detail, including the axillary known to him, as 
he described it placed entirely beneath the skin above the elbow joint, 
from which he then wrote the offshoot originates that deep down 
joins with a branch of the humeral vein. So when I regularly dem¬ 
onstrate that we see these things, and do so in a great meeting of the 
most learned men with cadavers present and meticulously compare 

them to Galen’s descriptions, I should certainly have deserved that 
Nature deprive me of eyes, if I had not protested rather to Galen 
than to her who is not to be accused of negligence, and I should have 
showed myself falsely accusing the exquisite designs of Nature and 
unworthy of my hands and eyes. 

Since this dispute about the veins of the arms must be referred 
rather to faulty descriptions or to things that Galen omitted than to 
my demonstration that Galen dissected apes and not humans, I shall 
now abandon it altogether and take my account to other organs. 

Reasons taken from the nerves hy which it is known that 
humans were not dissected by Galen 

An account of the distribution of the vessels is too troublesome for me 
to think that other differences therein should be explained. For this 
reason, I shall be more brief in explaining differences of the nerves. I 
shall call attention to only one that should not be neglected: it occurs 
around the nerves of the sacrum and coccyx. In man, six pairs of 
nerves belong to the sacrum; the first comes out between the upper 
part of the sacrum and the lowest lumbar vertebra and has nothing 
peculiar to it compared to those belonging to the thoracic and lumbar 
vertebrae. The five lower pairs, however, do not come out in that way 
from the sacrum, but before they exit the foramen of the sacrum pro¬ 
vided for the dorsal medulla, the nerves separate from each other on 
each side, with one portion going forward and the other to the rear, 
in the same fashion in which we have said the foramina of the human 
sacrum are elegantly carved out, with the dorsal medulla coming out 
of the end of the sacrum in the posterior area. In simians, though, the 
first pair of nerves of the sacrum, and then the other two, have the 
same egress as the human nerves, but no more than those three pairs 
can be ascribed to the sacrum. The dorsal medulla does not end there 
but passes through the ossicles which Galen identified as the coccyx 
and which in appearance very much resemble lumbar vertebrae; it 


sends out the same number of nerve pairs as pass through the 
ossicles; Galen thought there were three in simians and for that reason 
ascribed three pairs to the coccyx. But the fact is that no nerve hangs 
from the actual coccyx in man, nor does the dorsal medulla extend 
into it. 110 It should not be neglected that in caudate apes and dogs 
there are not just three pairs belonging to the ossicles of the coccyx, 
but as many as they have of such ossicles; the nerve pairs must be 
counted by the increased number. 

In Galen’s book De ossibus the description is applicable to sim¬ 
ians in the arrangement of nerves, but not at all to man. * * 111 In the 
fragment On the Dissection of Nerves, which I would like not to be 8 
ascribed to Galen, or at least to be considered corrupt, no mention 
is made of those nerves. How well he dissected them when he wrote 
De usu partium, nobody doubts who knows that he then had counted 
or knew only four bones below the lumbar vertebrae. But because in 
that work he does not make a great error in counting the number of 
pairs, I am forced to believe that he there made use of the works of 
other anatomists who dissected humans. Besides, from the descrip¬ 
tions of the series of nerves going to the arm and the femur as I am 
accustomed to show it at the universities, I conclude for my part from 
a comparison with Galen’s descriptions that it is very clear that they 
are not in agreement. Whether that must be in every case blamed on 
the distinction between simians and humans, I am unwilling to sug¬ 
gest because I have not thoroughly dissected the nerves of simians. 

Reasons selected from the contents of the peritoneum 

But now it is time to bring into my argument some differences in 
the viscera and cavities of the body, where the site of the omentum 

110 For this account of Galen’s version of the nerves in the sacrum and coccyx, see 

Fabrica Book IV ch. 16: “Distribution of the Nerves Coming from the Sacrum.” 

111 Galen wrote “The sacrum is composed of three parts, intrinsic vertebrae, as it were, 
of its own, at the end of which lies a fourth, another bone, called coccyx. When 


first becomes visible (I will pass over in silence the hardness of the 
peritoneum in pigs and simians, which Galen’s dissections thereabouts 
readily acknowledge in those animals, though because it is thin and 
soft in humans I am seldom granted my wish to dissect). You will 
find very few humans indeed in whom the omentum is seen wrap¬ 
ping the intestines as far as the pubic region. But to a great extent 
it is seen drawn up on its lowest side above the region of the colon, 
which extends along the stomach for the width of the body; this 
region descends on the left side more than the right, never reach¬ 
ing the region of the umbilicus, though by using the hands it can be 
pulled downward to cover the intestines as far as the pubes. But in 
simians and dogs, it is always so extended over all the intestines that it 
exists between the bladder and the rectum in males and in females 
between the uterus and the bladder. I know that humans have been 
called STnirAoKopiaTca 112 by some from the bulk of the omentum and 
its way of being carried, and that Galen believed for this reason that 
man has the largest omentum. But I believe in my judgment that pigs, 
dogs, and simians possess a much greater omentum than man, as I am 
forced to conjecture from people consumed by wasting disease and 
again from extremely obese women. An abdomen that stands out a 
foot and a half in these especially fat humans, as perhaps Galen had 

they are all cleaned by boiling, the structure [of the sacrum] is seen to be the same 
as that of the vertebrae. The nerves from the spinal cord, issuing through its foram¬ 
ina, pass out of its would-be “vertebrae” just as they do along the spinal column as 
a whole, yet not from its sides but internally and externally. There are three pairs of 
them.” (De ossibus ad tirones 2.762.6—14, tr. Singer 1952, 772). 

112 “Possessing an omentum.” Galen De optima doctrina 556 (LSJ).The Greek word 
is garbled in the Basel edition; the form as given in the Venice 1546 edition is 
£TriTrAoKO(JiaTds (the accusative form).The nominative spelling known toVesalius 
was probably surnAooKopiaTCQ, as in Galen De anat. adm. 2.556.13:“[the omentum] 
is largest in men and apes. For this reason many men are called ‘epiploon carriers.’ 
They give this name to the hernia [epiplocele] formed when the omentum breaks 
into the passage to the testicles.” (tr. Singer 1956, 157).The end of FabricaV ch. 4 
spells it with a single o. 


convinced himself, does not in fact have that mass and enlargement in 
the least degree from the omentum. 111 Though Galen had that per¬ 
ception, it need not be surprising because it is nowhere clear that he 
knew that fat is located between the skin and the fleshy membrane, as 
I mentioned previously. 

A more noteworthy difference, from which you may learn that 
Galen did not dissect a human, comes from the connection of the 

Illustration of the omentum from Fabrica 
Vfig. 4. In the upper left, I is the “stem 
of the portal vein where it issues from 
the liver, contained and supported by the 
lower membrane of the omentum.” The 
rim of the omentum, marked by three 
letters e, is described as the “circle or ori- 
ce of the omentum, from which it takes 
its beginning. ” 

omentum to the colon. In dogs, 
the omentum is not attached to 
the intestines by so much as a fiber; 
but in humans, the entire portion 
of the colon that extends from 
the spleen beneath the liver is not 
attached to the spine by means of 
any body nor is it contained so to speak by the mesentery; it is sup¬ 
ported by the membrane which is not identified as the omentum by 
Aristotle and many anatomists on the basis of human dissection, but 
I must take it for the omentum’s lower membrane. Just as the lower 

113 But see Gray’s Anatomy, 39th edition (2005) p. 1132: “The greater omentum ... 
always carries some adipose tissue and is a common site for storage of fat in obese 
individuals, particularly males.” 


membrane of the omentum in dogs and apes supports the series of 
the portal vein, arteries, and nerves, the glandular body spread beneath 
the back of the stomach contains it. This membrane braces the colon 
to the spine in humans, and then the lower or rather posterior part of 

the omentum that covers the 
intestines beneath the colon 
takes its beginning, so to speak, 
from the colon and is not man¬ 
ifestly continuous with that 
part of the omentum which 
we said takes the place of the 
mesentery for the colon here 
in humans. In simians, however, 
the continuity appears virtually 
the same as in dogs, and it is 

The colon as illustrated in Fabrica 
Bk. 5 jig. 8. The cecum is marked 
O. The 1555 edition of the Fabrica 
adds “This very thin, small appen¬ 
dix, twisted like a worm, is called 
by us the blind intestine [intesti- 
num caecum]. ” 

attached to the colon only by a number of fibers, and rarely in simians 
by a separate connection (as was correctly written by Galen). 

80 Therefore simians have a structure halfway between humans 

and dogs , 114 and it should be considered perfectly evident that in his 

114 Cf. FabricaV ch. 4 on the connection of the omentum with the colon: “The fact 
that apes have a nature midway between dogs and humans explains why Galen said 
that the omentum is attached to the colon by a few loose connections, and only on 
the right side. For in dogs the omentum is nowhere attached to the colon or any 
other intestine, while in apes it is intermediate, though they are still closer to the 
construction of the dog than the human.” 


account of the omentum Galen described the ape and not the human. 

It will be clearly understood whether this is also the case in the intes¬ 
tines when we have seen that the cecum is spacious and large in dogs 
and still larger in dormice and squirrels, and in those cases originating 
as if from the right side of the colon, or continuous with the colon, 
whereas in man we have seen that the cecum is a thin body twisted like 
a worm, brought out here from the beginning of the colon more on 
the left side and positioned, like the cecum of dogs, in the right flank. 

If, I say, we have considered these things, we shall no doubt deny 
that Galen examined the intestines of man, and from his account we 
agree that all doctors who have followed Galen imagine a certain sac in 
man, though that thin body in humans should nowhere be counted in 
the number of large intestines. There should also be no doubt that the 
ancients called it the blind intestine. But if someone studies the simple 
series of intestines in a dog near the right kidney and then notices the 
globular swelling at the beginning of the human colon, the attach¬ 
ment to it of the small intestines, and the beginning of the appendage 
called the cecum, he will not neglect their need for an extended and 
elegant description. In my judgment he will immediately admit that 
Galen had not scrutinized them in man; likewise, he left no account in 
his books except what he could make to fit a dog. Indeed, if I had not 
carefully examined the innards of a dog and determined that Galen 
had written his account only about apes, I would say that Galen had 
mentioned the cecum because of the opinion of other anatomists. 
This is because (if I remember correctly) caudate apes differ from dogs 
in having no cecum, besides the fact that when Galen enumerates 8 
the intestines he makes no mention of the cecum. 

But if we grant that these are small items, with what negligence, 

I ask, are we to think that Galen omitted the curvature and course 
of the colon which it makes toward the umbilicus on the right side 
where it is conterminous with the rectum, if he had noticed it in man 
in such a way that he saw that in dogs the colon is carried with no 
such curvature? He also does not mention the turn that the colon 


makes above the spleen, which must be fully weighed by doctors 
when they discuss colic pain on the left side. 

In addition, to free myself eventually from the intestines, if Galen 
had viewed human intestines as much as he did those of the pig and 
the cow, and had not thought that human intestines resemble those of 
dogs and apes, we would not read in his writings that the colon of cer¬ 
tain animals has powerful ligaments and bulges as if into little spheres 
on each side. Without doubt he attributed such a form of the colon to 
man without distinguishing him from animals that have a colon con¬ 
forming to this image. You should never forget how much the form 
and structure of the colon in man and the pig differs from the intestine 
of dogs, which Galen described instead of the human intestine. 

We are able to learn from Galen and from anatomists who fol¬ 
low him that the liver is not so conspicuously divided into five lobes 
or fibres, 115 and embraces the stomach like a hand. 116 It is clear, how¬ 
ever, that Galen thought the liver was divided into fibres from the 
eighteenth [Hippocratic] aphorism of the sixth section;" 7 as in sim¬ 
ians, dogs, and pigs we see it partitioned in such a way that they do 
not appear attached by the peculiar substance of the liver. But the 
human liver is a single, continuous body, in no way divided into fibres. 
The small cleft by which it admits the vein that leaves the umbilicus 
82 is so slight that the liver should by no means be thought divided by 
it into two fibres < , since the cleft does not cut even a sixth of the 

115 Latin admits two meanings for fibra: a filament-like strand, or a part or division, such 
as a lobe of the liver. The latter carried over into English, though this meaning is 
now obsolete. 

116 This error of Galen andVesalius’ own predecessors was taken up in FabricaV ch. 
7 in the section titled “The form of the human liver differs from that of dogs and 
pigs.” Vesalius himself had illustrated a human liver with five lobes in his Tabulae 
Anatomicae of 1538. 

117 The only Hippocratic text that mentions a five-lobed Ever is De ossium natura 1.11. 
This paragraph on the construction of the liver recapitulates FabricaV ch. 7, partic¬ 
ularly the section headed “The form of the human liver differs from that of dogs 
and pigs.” 


liver’s thickness. No one should therefore doubt that Galen had not 
observed a human liver. 

I shall pass over the ligament [lig.falciforme hepatis] given to man 
but not to dogs or caudate apes, which travels in a straight line from 
the front of the body posteriorly and binds the liver to the transverse 
septum, crossing from the right side of the vena cava through the sep¬ 
tum. Corresponding to this is the attachment of the liver in man to 
the front of the peritoneum; it is always present in humans, not as in 
dogs, by means of the vein [ligamentum teres hepatis] running from the 
umbilicus to the liver. 

It is the opinion of Galen that this vein and the arteries peculiar 
to the fetus, together with the passage that carries urine from the 
bladder between the innermost and the second wrapping of the fetus, 

Detail of fig. 12 in Fabrica V, 
showing the single-lobed liver 
(K) pulled upward. The oblit¬ 
erated umbilical vein, which 
after birth becomes the liga¬ 
mentum teres, is labeled M. 

are completely resorbed 
in animals after birth, just 
as in dogs that are not 
very old there is no trace 
of these vessels. However, in humans into extreme old age those four 
organs are seen in dissection; they are not in fact hollow and perform¬ 
ing the same functions as before birth, but appear like cords and are 
nurtured by a great deal of fat. Therefore the umbilical vein performs 
as a very elegant attachment for the human liver, by which it is con¬ 
nected (as I was saying a little earlier) to the front of the peritoneum. 

For the same reason, however, the connection of the bladder 
to the peritoneum is an indicator that the human bladder was not 

observed by Galen. For we see that the bladder of the dog and the ape, 
like that of the steer and the sheep, throughout its body or base is not 
attached to the peritoneum by some process or light membranous lig¬ 
ament, while the entire anterior surface of the human bladder is quite 
tenaciously attached to the peritoneum and in no place separates from 
it, except that the aforementioned fetal arteries and the passage pro¬ 
vided for fetal urine contribute in no small way to this connection and 
produce a far different type of attachment to the bladder in humans 
than in the animals mentioned. 

How important this distinction is to consider I judge to be no 
trivial matter, because I know from experience that so many wounds 
that penetrate from the pubes into the space of the bladder, and there¬ 
fore provide a path for urine, are easily treated. But if the attachment 
of the bladder to the peritoneum were the same in man as in the dog, 
and no greater than the connection to the intestines or the stom¬ 
ach, there would be no hope remaining for the treatment of those 

In addition, if Galen had described the site of the spleen and its 
connection to the stomach a little more completely, we should be able 
to question whether he believed from the dissection of dogs that the 
spleen is located so much in the anterior of the body and down by the 
lowest part of the stomach, and as obscurely attached as most doctors 
and anatomists believe; for the difference between man and the dog 
or the ape in this part is not slight. 

From the lengthy study of the penis in Galen, 118 a description 
in which he seems to have taken great satisfaction, and then from 

118 Vesalius’ disagreement with Galen about the structure of the penis is more clearly 
stated in his chapter on the penis in FabricaV (ch. 14). In bk. 15 of De usu partium, 
Galen called the corpus cavernosum a “sinewy (vsupcoSss), hollow body growing 
out devoid of moisture from the bones called pubic... it grows out from bone as all 
the other ligaments do ... and is the only one of them all to be hollow” (4.217.14— 
218.6, tr. May 1968, 658). The “hollow” in Galen’s description probably refers to 
the corpora cavernosa which flank the corpus spongiosum and the penile urethra 
(but do not in fact grow out of the pubic bones). Vesalius himself believed that the 


a painstaking dissection of the male member, nothing is more clear 
than that it had never been examined by Galen. While carefully inves¬ 
tigating the method of its composition, and bearing in mind that of 
cattle and bulls, which we employ in preparing straps and sometimes 
certain shackles, I learn that it fashions some hollow sinew, and brings 
forth many other things having little resemblance to the two bod¬ 
ies that principally form the human penis; these consist of a spongy 
and somewhat fleshy substance enfolded in a very thick membrane. 
Aristotle, 119 or the person from whose account he wrote anatomy, 
appears not to have noticed this even in passing. So nothing will more 
manifestly show that Galen’s description is at variance with the con¬ 
struction of man in many respects than my own quite lengthy account, 
which cannot be repeated here because of its length, or a compari¬ 
son in dissection with the human penis; nothing is more manifest 
than the things I have plainly explained, which are evident without 
dissection — those matters came to be scrutinized because of him. 

As the uterus has a great number of features worth our attention 
in its position, shape, attachment, substance, insertion of vessels, and in 
all the things that we examine in the study of the parts, it has a great 
many features worthy of attention, which cannot be contained in an 
easy or short description. They come primarily from Galen, in Attic 
Greek, and they did not escape hard work in writing. It should not 
seem strange if when he wrote the special book De uteri dissectione, 
many things come to mind from my general conjecture that he did 
not dissect humans, that add strength to my opinion. 

This first thing to be noticed in his book De uteri dissectione 
testifies more than once that the uterus of the cow and the goat is, 

corpus cavernosum originates from the pubic bone; Galen’s error therefore lay in 
implying that there is only a single such body. The ligamentum suspensorium penis is 
the only part originating from the pubic bone, but it is unmentioned by Galen or 

119 In bk. 1 ch. 13 of Historia animalium (493a26), the fleshy part Aristotle mentions is 
only the tip or glans.The rest of the penis, he says, is cartilaginous, xovSpcoSss.This 
describes the penis of certain animals but not of man. 

as predetermined, like that of a woman, 
and he does not mention any difference 
between those uteri, except that because 
of the authority of other experts in dis¬ 
section he dared not contradict anyone 
openly for what they had written privately 
to anyone about the human uterus that 
did not occur also in their bovine uteri. 
Galen says that they should not lightly be 
contradicted because they acquired their 
knowledge of anatomy not in brute ani¬ 
mals but in humans. 120 He does not make 
the same claim for himself but brings his 

Illustration of the Galenic bovine uterus from 
Fabrica V fig. 29, showing the division into 
two horns that most distinguishes it from the 
human uterus. “In the end,” wrote Vesalius, 
“the student will learn that Galen never 
inspected a woman’s uterus even in his dreams; 
he saw only those of cows, goats, and sheep. ” 
(Bk.Vch. 15). 

apes into his account instead of women. Though some professors of 
anatomy mentioned by Galen had described the uterus of goats and 
cows (Praxagoras was one of them), passing on contradictions of earlier 
writers, those present at my dissections would observe in the medical 
schools with some pleasure how anxious Galen appeared about those 
whose opinions he must agree with and what had to be universally 

120 See Galen De uteri dissectione 2.895.7—14: ‘“Not in the case of all women but in 
some,’ says Herophilus, ‘four other vessels branch off from those that go to the kid¬ 
neys, and enter the uterus.’This I did not find in other living beings, except occa¬ 
sionally in apes. I do not, however, disbelieve the fact that Herophilus often found 
them in women. For he was not only competent in other branches of the art [of 


established about the uterus. Because he found the descriptions by 
later writers in cows, he attributed these only to earlier writers and 
knew the descriptions were not of dissected women, but he was not 
willing to dispute their opinion openly 

Since, therefore, the human uterus differs greatly from the bovine, 
proofs are easy to find by which it can be clearly known that Galen 
did not dissect a human uterus. The cow’s uterus goes beyond the 
position of the sacrum, angling downward from the rectum and above 
the vessels running upward along the loins where the lowest lumbar 
vertebrae stand.Thus Galen’s description squares here with the human, 
though the non-pregnant human uterus does not ascend so high in 
position that it comes within a long distance of reaching the point 
where the sacrum is joined to the lowest lumbar vertebra. Nor does it 
go upward beyond the bladder, as do the uteri of cows and dogs. The 
cervix or neck [vagina] of the uterus in quadrupeds is extremely long, 
and straighter than that of the human uterus. It will therefore be sur¬ 
prising to no one that for this reason its position is different. From this 
different position, we cannot 
be in doubt that Galen mea¬ 
sured the length of the neck 
of the woman’s uterus only 
in fingers from the length of 
the man’s penis. Otherwise 

Detail of fig. 25 in Fabrica Vf 
showing the human uterus (i, 
k, 1) “somewhat round, like the 
bladder’’ (a, (3), which has been 
turned forward to the left. 

medicine], but he attained the highest degree of accuracy in things which become 
known by dissection and he obtained the greater part of his new knowledge, not, 
like the majority [of physicians], from irrational animals but from human beings 
themselves.” (tr. von Staden 1989, 220). 


he would not have ascribed such a high position to the uterus, if the 
neck stood together with the uterus. In describing the form of the 
uterus, Galen seems to agree with the opinion of Herophilus when 
he compares it with the bladder. But later he no longer agrees with 
himself when in arguing about the horns he to some extent makes 
his own use of Herophilus’ words that fit women. As he proceeds, he 
judges by a different opinion expressed by anatomists, and then as he 
affirms that the bovine uterus is like the human he disgraces himself 
by wrongly describing the horns and shape of the human uterus dif¬ 
ferently from Herophilus. 

The human uterus is somewhat round, like the bladder, com¬ 
pressed in front and behind and accordingly wider than it is deep. 
On its upper side, it also appears somewhat depressed, and resembles a 
quarter-circle or crescent moon. Otherwise, if it bulged like the blad¬ 
der, it would form a semicircle of a complete circle. So the upper part 
of the uterus ends in a kind of swellings like those on the head of a calf 
because it will soon bring forth horns. These swellings or peaks were 
probably what Herophilus called the horns on the woman’s uterus. 
In dogs and pigs the uterus is split into two parts immediately after 
the meeting of its fundus with the cervix \vagina \, as if you separated 
the index finger from the middle finger as far as possible and imag¬ 
ined each finger to be one part of the uterus. These do not appear 
bent in non-pregnant animals, but in those that are pregnant they are 
curved according to the number of fetuses. Those are contained one 
after another in these parts of the uterus; hence those who have told 
the anatomy of such animals from dissection have called those parts of 
the uterus horns because they closely resemble a large and prominent 
horn, and they say fetuses are conveniently contained and enclosed 
by them. 

In cows, however, everything is different. If you look at the fun¬ 
dus of the uterus in one piece and with its outermost wrapping still 
in place, it is seen to be simple, borne from its neck upwards on a 
long course, not round in shape but rather thinly rounded in front 


and behind and compressed as if two fingers were placed against each 
other and covered by a fascia. Then the fundus is separated as if into 
two ram’s horns separating from each other. I do not know whether 
you would liken anything in the entire body more similar to some¬ 
thing else than you could compare these parts of the cow’s uterus to 
a ram’s horns. 

And since the fetus is located lower down in the other part 
of the fundus (for it is double, as I shall soon say) lower than in the 
separation into the uterine horns, and since therefore the fetus is so 
to speak not contained in them, why is it surprising that Galen is so 
muddled in his description of the horns? Why is it surprising that 
there are conflicting doctrines of anatomists about the quite different 
kinds of uterus? On the other hand, it is a fine and intelligent thing 
that he thought himself extricated when he believed that the action 
and function of the horns should be assigned to another place which 
you will never find in his writings. 

The entry of seminal vessels occurs for all uteri in its farthest 
peaks; in women, it occurs in the protuberant heads on each side of 
the upper part of the uterus; 121 in dogs, at protuberances of the top 
of the parts which we have compared to fingers separated from each 

As in cows, the oviducts are beautifully folded into the peaks of 
the parts of the uterus that resemble ram’s horns. As Galen has also 
well noticed, this feature was missed by other anatomists. 

I cannot sufficiently judge, however, what vessels Galen writes 
about that are inserted into the neck of the bladder and were known 
to Herophilus and others whom he was afraid to contradict because 
of the great precision that marks their description of other parts. 122 
It appears Galen believed that in women as in men what we call the 


121 At i and k in the preceding illustration. 

122 A reference to the pampiniform venous plexus in the male. In FabricaV ch. 13, he 
writes “if I rightly understand Galen’s view in De semine, in one place he wants 
these turnings to be called the KipaosiSps TTapaaTaTps as Herophilus believed, 


glandular assistant was attached to the neck of the female bladder, and 
then discovered the vessels that are implanted from the ovaries 12 ' into 
the neck of the bladder at that body in women. If Galen read that in 
Herophilus, and he himself held the same view, I am willing to say that 
I found that glandular body but I did not also find the seminal vessels 
brought from the ovaries in women or in animals. Indeed, I shall dis¬ 
trust the authority of Galen in this part until I have heard that such 
things have been found by someone in bodies and am told by what 
means I may study those matters. Meanwhile, I consider none of them 
a necessity for women. 

I would not want to fabricate anything here about the coitus 
of pregnant women, about whom it is universally agreed that the 
mouth of the uterus is tightly closed. My opinion is the same regard¬ 
ing the veins and arteries going to the uterus, except for the vessels 
delivering the material of semen from those that are borne into the 
kidneys. Herophilus said that these are seen in some women, so Galen 
did not doubt that he had found them in many women. 124 He would 
have written otherwise if he had ever dissected a woman himself, and 
had observed that they are absent exactly as they are in apes. When 

while elsewhere he applies that name to another part of the body we are now 
describing, where it is inserted in the penis.” In De semine 4.565.14, Galen identi¬ 
fied this term with the ductus deferens as a whole; in 4.567.13, he applied it to the 
distended end or ampulla of the ductus deferens (or perhaps the seminal vesicle) 
at the base of the bladder. In 4.582.15 he says “Herophilus gave the name ‘varicose 
helper’ to the part of this vessel that lies close to the penis.” In 4.587.1 ff. he again 
identifies it with the ampulla: “In animals that have abstained from congress with 
the female all the parts are full of semen, first the varicose helper, then the entire 
spermatic duct, then the epididymis, then the entire testicle, etc.” (tr. De Lacy 1992, 

123 Lat. a testibus ; for the sake of clarity we are translating Vesalius’ female “testes” as the 
ovaries. It should likewise be remembered that the female “seminal vessels” are the 

124 In FabricaV ch. 15,Vesalius had written “In many places Galen agrees with Herophilus 
(who he knew had dissected human bodies) almost against his own judgment, not will¬ 
ingly admitting — though he had never seen one — that he was not describing a human 
uterus.” He refers there to Galen De uteri dissectione 2.895.7—14 (see n. 120 above). 


he says that he had found those veins and arteries only on the rarest 
occasions in simians, I am convinced he had written that in the same 
way I do when describing a different set of nerves and vessels in some 
places and am compelled to add that it occurs sometimes in one way 
and sometimes another, - because I am at first afraid to contradict 
Galen even though I had always observed otherwise. Similar to that 
are places in my writings regarding the origin of the humeral vein 
from the vena cava, the distribution of nerves in the lower leg and the 
foot, and the meeting of certain nerves in the upper arm. 

However, I must return to the subject of the uterus, whose con¬ 
tact with other parts proves beyond doubt that Galen did not see its 
position and shape and only imagined how they are in women. He 
describes its size inaccurately, thinking that the fundus of the uterus in 
women is much larger than it appears in reality; I never saw the uterus 
of a non-pregnant woman to which I could assign a breadth of three 
fingers, nor did the length of the fundus ever exceed three fingers’ 
width. The length of the vagina proved itself variable proportionate 
to its extension, for it is a membranous, sinewy body and accordingly 
more pliant than some would suppose. I therefore believe, from the 
difference between the womans pudendum and that of cows and 
goats, that Galen thought the human vagina was equally muscular and 
fleshy, and described it differently than it is in fact. 

Again, as Galen correctly described two cavities in the bovine 
uterus whereas it is a single one in a woman, so too he rightly 
described the tunics of the bovine uterus but was quite wrong in 
the construction of the human uterus. There is a single tunic in the 
woman, which is wrapped differently from the peritoneum and the 
ligaments containing the uterus. In cows, however, as we said the fun¬ 
dus of the uterus is immediately divided into two parts, so too each 
part is formed with its own peculiar tunic. This is why Galen put it 
out that the uterine tunic is in two parts, one of which is covered by 
the peritoneum, and it has this instead of only one because it wraps 
the two parts of the fundus at one time so that no seam will come 



between the two parts like a fascia with which you would wrap two 
fingers or the roots and beginnings of a ram’s horns together. As the 
uterus is shaped, so too is the difference in the tunics because of 
the division of the uterus, where Galen did not know that the human 
uterus differs from the bovine. 

For the present, while wishing to avoid lengthening my remarks 
about the uterus too far, I must not pass over the place in his book On 
the Dissection of the Uterus where Galen seems to me as worried and 
perplexed as we sometimes feel when our mind changes and is driven 

one way and another whenever we 
are overwhelmed by the opposing 
opinions of authors. Galen had read 
that the leading professors of dissec¬ 
tion held that the human uterus had 

Vesalius added this figure of the bovine 
fetus and its mappings to the 1555 edi¬ 
tion of the Fabrica to illustrate the coty¬ 
ledons or acetabula of ruminants (marked 
B): “We add this figure to those supplied to 
demonstrate the parts in man, to show the 
difference between the fetal wrappings of 
cows, bovines, goats, deer, and other horned 
animals, as well as animals truly showing 
acetabula in their uterus after conception. ” 

no acetabula, 125 but attributed them to the uteri of horned animals; 
others, however, who thought as Galen did that the bovine uterus was 
like the human, held that the uterus did have acetabula. Hippocrates 

125 Cotyledons [tunica mucosa, glandulae uterinae ]. The discussion of acetabula that fol¬ 
lows is related to Bk. V ch. 16 of the Fabrica, “On the Acetabula of the Uterus.” 
Such acetabula, pea-shaped pits in the cavity of bovine and canine uteri, are to be 
distinguished from deep cavities in bones, such as the cup-shaped socket in the hip 
bone that receives the heard of the femur. 


agreed with this: in his Aphorisms he mentions acetabula, 126 meaning 
something much different by that name than whoever established this 
name in dissections, as no one need be in doubt who has undertaken 
the dissection of various uteri. 12 ' It is quite clear to me that the name 
acetabulum was applied by authors to three different things, so that 
Galen should have recognized from his knowledge of the thing what 
each one meant. First, we use the name acetabulum in describing 
round, hemispherical hollow cavities, in this way calling all deep cavi¬ 
ties in bones, primarily the cavity of the hip bone in which the head 
of the femur is received, an acetabulum. The name, as I have used it in 
my book, is taken from the shape of the herb that we call acetabulum, 
garden ofVenus, or umbilicus, and a measure for vinegar. Now in the 
uterus of a cow, a ewe, a bovine, or a doe that has recently conceived, 
numerous pits are seen which protrude with their lips into the cavity 
of the uterus and are hollowed as if someone had pressed halves of 
peas into them. Therefore, no one who takes my advice should be in 
doubt that such depressions were first named acetabula. 

Since these arise and are made out of swellings visible in a 
uterus that is not pregnant, like the ones that anatomists have com¬ 
pared to veins standing out in the anus from which blood often issues 
at intervals, it is not surprising that the alternative name acetabulum 
is applied to those swellings; but that is quite inappropriate, since they 
are not depressions unless the horned animal has kept its reproductive 
power for some time. 

126 The 45th Aphorism: “If moderately well-nourished women miscarry without any 
obvious cause two or three months after conception, the cotyledons of the womb 
are full of mucus, and break, being unable to retain the unborn child because of its 
weight.” (Loeb tr. by W. H. S. Jones).This Aphorism was cited in Galen’s De uteri dis- 
sectione 2.905.1—906.5 with the following statement by Galen: “The cotyledons are 
the safe attachment between the placenta and the womb.They say the human womb 
does not have cotyledons, but they exist in the wombs of cows, goats, deer, and such 
other animals, being loose bodies, somewhat mucous, in their appearance resembling 
the cotyledon in grass, the little cymbal, from which they take their name,” etc. 

127 The end of this sentence is garbled and cannot be construed with any certainty. 


10 7 

Again, because veins and arteries into the outermost wrap¬ 
ping of the fetus are formed out of those pockets, it should not be 
a surprise that those veins and arteries newly generated between 
the wrapping and the inner surface of the uterus are called acetab- 
ula by some people. It is all too clear that Hippocrates employed 
this term when he wrote his account of abortion in the second 
or third month and explained as the reason (which he otherwise 
almost always passed over in silence) the mucus with which those 
new, weak vessels swelled by which the fetus is supported. It is cer¬ 
tain that the two-month fetus and to a much smaller degree the 
three-month fetus even in cows is retained only by those depres¬ 
sions or rough places, just as we all know cuttlefish and squid cling 
to cliffs and rough places with their proboscis, which we see is full 
of acetabula. 

Because these vessels occur in women as they do in cows, the 
name acetabulum would for that reason not be wrongly attributed to 
a woman in that sense. But because the human uterus does not show 
the swellings standing out in its interior, and because in the absence 
of swellings the depressions carved out in the shape of the socket in 
the hip bone cannot exist, it is clear that neither the first nor the sec¬ 
ond name of the acetabula can be applied to a woman. Galen would 
therefore not have been confused if he had also occupied himself with 
a human uterus as opposed to a bovine. 

Some conjectures based upon the parts that are contained 
in the thorax 


There is also considerable difference in the wrappings of the fetus, but 
we shall better save them for the untrue descriptions and direct our 
attention to the second cavity of the body, the thorax. This will be 
briefer because of the aforementioned course of the vena cava, in 
describing which I stated how the membranes that divide the thorax 
in dogs and apes constitute a major cavity above the sinewy part of 


the transverse septum and beneath the wrapping of the canine heart 
that does not occur in man. Neither is the peculiar lobe or fiber of 
the lung found there, which occupies that cavity and would support 
the vena cava like a hand or elegant fulcrum as it passes that way and 
deliver it safely; Galen called this the fifth fiber of the lung. 128 But in 
fact you will find two on the right and two on the left side; this cavity 
and that fiber of the lung clearly prove that Galen dissected apes and 
dogs but not humans. 

The same is true of the wrapping of the heart, which Galen says is 
separate from the transverse septum and not attached to it; it is clearly 
as much removed from the septum in dogs and apes as is the afore¬ 
mentioned cavity. But in man, the wrapping of the heart is attached 
and united over a large area to the sinewy region of the transverse sep¬ 
tum and occupies an altogether different site in man than in dogs and 
apes according to the difference in the heart’s location.That is because 
it is necessary for the small arch and wrapping of the heart to have 
the same location as the septum. It is clearly established by anatomy 
and reason that the position of the heart is different in humans than in 
dogs and apes. For if we think about the length of the breastbone in 
humans and compare that with the canine breastbone, we will readily 
be aware that the human heart is as a rule proportionately very large 
and occupies a position not as vertical and along the length of the 
body as Galen ascribes to the heart in simians and dogs and we see 
clearly in dissection. Because the base of the human heart occupies 

128 The Fabrica takes up this error in Galenic anatomy in Bk.VI ch. 7: “I still remem- 
ber the passage of Galen in the seventh book of De anatomicis administrationibus 
where he says that this fifth lobe of the lung does not escape the notice of those 
who dissect correctly. He implies that this lobe was unknown to Herophilus and 
Marinus, as it surely was because they dissected the cadavers of humans, and not, 
like Galen, those of apes and dogs, in which nothing is easier to see than the present 
lobe. Likewise, it is perfectly clear to anyone who dissects a human that the fifth 
lobe is not present.” Galen had written “there is also a fifth small lobe in the right 
lung, a mere offshoot of one of the others.” (De anat. adm. 2.625.12 ff., tr. Singer 


the middle of the thorax between left and right, and is located some¬ 
what transversely, the remaining body of the heart is borne quite 
obliquely downward to the left side, leaning on the left side of the 
transverse septum just as I said the wrapping is attached there to the 
septum. It is as if the human heart were forced to take this transverse 
position and were unable to be taken freely straight down. 

So we know how the canine heart is placed: it inclines somewhat 
with its point but not its entire body from an oblique position upward 
to the left side. Because Galen had observed this position in dogs and 
apes but had never dissected a human, it should come as no surprise 
to us that he never mentioned the position of the human heart, and 
that Galen, not content with a simple explanation of its place, in fact 
goes to some length to criticize Aristotle and others who revealed its 
position to us as it is in dissection and as reason also dictates. 

Reasons taken from those contained in the skull 

So far as the brain is concerned, it is perfectly clear that the brains of 
cattle were provided by Galen for inspection and dissection, since in 
his writings there is no mention of another animal’s brain. Because 
there is no great distinction between the brains of cattle, wild animals, 
other animals, and humans, there are few grounds for conjecture that 
Galen did not dissect humans in the third cavity of the body, namely 
the skull. One of these grounds, not the common one, has to do with 
the position and shape of the cerebellum. In cattle, as Galen’s descrip¬ 
tion also has it, the cerebellum occupies the back of the occiput, taken 
to the rear beyond the posterior region of the cerebrum, whereas in 
man it is placed altogether beneath the cerebrum, and the farthest part 
of the cerebrum is extended much more to the rear and into the occi¬ 
put than the back of the cerebellum. 

Moreover, the cerebellum of the steer rises higher in the occi¬ 
put than that of man, whose cerebellum is wide and flattened on top, 
while the bovine cerebellum is round and spherical there and rises to 

the higher position of the suture that resembles a A. The top of the 
human cerebellum, however, stands only in the middle of the distance 
that is measured from the foramen carved out in the occipital bone 
for the dorsal medulla to the aforementioned location of the suture 
resembling a A. It is therefore not surprising that in his description 
of the place where the first two sinuses of the hard membrane meet, 
Galen clearly shows that he is practiced in the dissection of cattle 
but not of man. That place of meeting stands at the highest point of 
the aforementioned cerebellum, which differs from cattle in humans. 
Galen’s description fits the former well enough, but does not match 
the latter. 

It will be told how the network of arteries at the base of the 
cerebrum was seen by Galen in cattle more than humans when I 
endeavor a little later to show that he refrained from the truth in his 
account of things. At present I will seem to have gone too far in listing 
the differences between man and the other animals in order to prove 
that Galen did not look at the bodies of humans. I shall therefore put 
an end to those differences as soon as I have added that the chief rea¬ 
son for surprise in Galen is that in trusting his apes he so often con¬ 
tradicted the Ancient professors of anatomy without good reason and 
accused them of negligence on the ground that they either left out or 
described differently what he was finding in apes because they were 
observing those features in humans. 

Some places where Galen openly criticized the Ancients 
because they had dissected humans and not apes, as he did 

A place of this kind presents itself in his description of the sutures of 
the upper maxilla, where Galen writes that other anatomists did not 
see two sutures, or passed them over as if not worth consideration. 
But Galen based this opinion on the ape, while they were correctly 
describing the fabric of man. Similar to this is the process in the 

lumbar vertebrae that apes and dogs have: Galen writes that it had 
been overlooked and neglected by others, but nothing is more certain 

This figure from ch. 17 of Book I 
of the Fabrica illustrates a lumbar 
vertebra of the caudate ape, where 
H marks the small accessory process 
that Vesalius argued (wrongly) does 
not occur in humans. 

They had compared the 
entire pectoral bone to a sword, 
but Galen compared the pointed 
cartilage [processus xiphoideus] to a sword because of his apes and 
dogs. How frequently and at what length did Galen criticize the 
ancients for not recognizing the muscle formed from fleshy mem¬ 
brane at the side of the armpit and thorax? But this is not found in 
humans. 129 

He is no less pleased with himself that they had not observed 
some of the muscles raising the scapula. But we know from care¬ 
ful dissection that apes have two such muscles. 1 '" Again, who could 

129 probably refers to the m. panniculus carnosus, about which Vesalius wrote 
“Galen ... boasts continually that all the authorities in anatomy who preceded him 
had missed this muscle (while working on human bodies rather than on apes, like 
Galen), and that he had found it in apes. I have definitely seen it in apes, dogs, and 
many quadrupeds, but it is not equally wide or fleshy in all of them.” See Fabrica II 
ch. 23. By structuring his polemic in this Epistle as a defense of the ancients against 
the strictures of Galen, Vesalius assumes the antiquarian mantle of the Humanists, 
whose faith in prisca medicina was unquestioned. 

130 See the section titled “The muscle raising the scapula that is found in the ape” in 
Fabrica II ch. 26: “if you believe Galen you will blame yourself for ignorance and 
carelessness while dissecting when you go in search of additional muscles in man 
that lift the scapula.” 

excuse Galen for ascribing some negligence to others regarding the 
second pair of muscles moving the head? This muscle is positioned 
so differently in man from the ape or the dog, and Galen describes it 
no less than the muscles of man. 131 It is also known about the mus¬ 
cle inserted from the clavicle and pectoral bone into the mammillary 
process of the head and serving motions of the head, in describing 
which Galen attacks the ancients quite undeservedly on account of 
his apes. 

So too it is not surprising that Galen found fault with others 
for passing over the muscle that we see is part of the rectus abdom¬ 
inis muscle in caudate monkeys and dogs, running from the costal 
cartilages along the side of the pectoral bone to the clavicle, which 
humans lack altogether. 1 ’ 

For the same reason he criticizes other anatomists because they 
did not know of the muscle presented to the ribs from the upper cer¬ 
vical vertebrae, descending along the anterior surface of the muscle 
[m. serratus anterior] identified as the second of those moving the tho¬ 
rax; it is quite evident that this is lacking in man. 

When he mentions a portion of the larger muscle [in. adductor 
magnus\ which I count the fifth of those that move the femur and not 
among the movers of the tibia, and which is inserted by a tendon in 
the inner head of the femur, he criticizes others because they wrote 

131 See Fabrica II ch. 28; in the section titled “The second [pair] is quite various,” 
Vesalius remarked “Galen is without doubt seen to testify that many professors of 
anatomy counted not just two muscles of this pair: some numbered four, others six 
in the same area, though these were perhaps from the ranks of those who unlike 
Galen studied humans. In apes and dogs (about which I have spoken so far in 
describing this second pair) I would count only one muscle on each side, since 
if one had to pay attention to the impressions one would have to count the same 
number of muscles as there are origins from the transverse processes of the verte¬ 
brae and insertions into their spines. In man, I have observed that this combination 
of muscles is much different than Galen described it, or rather counted it.” 

132 See Fabrica II ch. 24, where in the section titled “Dissection of the first muscle 
moving the arm”Vesalius invited students to look for this costal part of the rectus 
abdominis, which occurs only in apes and dogs. 


that this insertion is accomplished by a tendon and not by a fleshy 
implantation as appeared to him in his apes. 

Likewise he carps at others for having written that tendons of 
muscles moving the tibia inserted in its anterior part are round and 
not wide as they are seen in simians. In addition, 5 how often did he 
attack certain people because they left out the muscle from which the 
hidden tendon of the foot originates? 133 The fact is that his descrip¬ 
tion does not fit humans, but rather simians. He censures others for 
not knowing that the fourth muscle moving the foot is implanted in 
the heel bone with a fleshy insertion, though it has a quite perfect 
tendon in humans as distinct from simians. 

But what more obviously proves the falsity of this accusation 
by Galen (to make no mention of the position of the heart and 
other locations of this kind) and his allegation of negligence than the 
course of the vena cava through the transverse septum and the fiber 
of the lung that supports it? When Galen cut up his monkeys and saw 
that they differed from the description of the ancients, who trained 
themselves on human dissections, 134 he did not scruple to state that 
they had not seen that fiber of the lung and who knows what else. 
I should therefore be thought more impious if I had not vindicated 
those Ancients with a true description of the human fabric. If because 
of the powerful devotion to Galen under which I labor and my special 
regard for him I were to leave his opinions everywhere undisturbed 
contrary to the testimony of my eyes and the truth of the matter, I 
should be willing to have my generation wander in confusion like all 
the ages that have followed Galen, and let his misrepresentation of the 
Greeks go undetected. 

133 This is explained in Fabrica II ch. 58 “On the Hidden Tendon Attached to the Sole 
of the Foot.” 

134 By the (sometimes capitalized) Ancients,Vesalius tacitly means not the Hippocratics, 
Aristotle, or Diodes but the pre-Galenic Hellenistic anatomists, of whom he men¬ 
tions a kind of pleiad consisting of Marinus, Eudemus, Herophilus, Andreas, and 
Lycus in the Preface of the Fabrica. 

Not everything in his description of the parts was 
correctly reported and described by Galen 

So it was, my Joachim, that when I responded to Sylvius in a letter 
such as this which presented itself too abundantly, to the point that he 
took offense at my argument that humans had not been dissected by 
Galen, I came to the point that Sylvius asserted that nothing wrong 
had been said or written by him. Here I first began to show how 
impious we should be toward Galen if in describing the fabric of man 
we should impute to him as many false descriptions as we find in his 
books discrepancies between man and the simian, and we would pro¬ 
tect his authority if we preferred to say more than once in explaining 
those descriptions that he taught Anatomy chiefly from his inspection 
of simians, and that he erred in determining that simians are too 
much like humans. I therefore believed that the things that differ in 
Galen from the human fabric because of his use of simians and brute 
animals should not be relegated to the category of variant descrip¬ 
tions; but a number of other descriptions, as they presented them¬ 
selves in the very large field of places little observed by Galen, I placed 
almost in this category. 


A number of untrue descriptions in the bones 

When Galen based the type of bones on epiphyses, he wrongly 
attributed epiphyses only to large, massive bones; but digital bones, 
carpal and tarsal bones, are perfectly well known to have epiphyses. 
Likewise, every part of the teeth outside the gums is clearly also an 
epiphysis in children. I say nothing of the vertebrae, which should 
also be included in the number of smaller bones; certain of these, as 
pretty well all the thoracic and lumbar vertebrae, we see also to have 
five epiphyses. These also prove (though Galen thought otherwise) 
that epiphyses belong not only to the large bones, which contain 


a large cavity filled with a marrow that is not separated by osseous 
fibers, for example the humerus, ulna, radius, femur, and the bones 
of the lower leg, but also to bones in which this cavity is not present. 
Neither the vertebrae, the scapula, the bones attached to the sides of 
the sacrum, nor the ribs have this cavity.Yet in those bones epiphyses 
are distinguished just as they are in the bones that I was saying are 
marked by that cavity. 

With this should be combined nearly everything about which 
I disagree with Galen in describing differences of bone construc¬ 
tion. For example, when Galen composed his account of them in his 
book De ossibus, under synarthrosis or articulation he should not have 
included suture, harmonia [sutura plana], and gomphosis, since they 
should have been placed under a single category together with sym¬ 
physis because it contains bone structures fabricated by Nature for no 
motion whatever. Opposed to that is the category of structure built 
for motion that is either manifest or obscure. 135 

Synarthrosis differs from diarthrosis only in the obscurity of 
motion, and both join in the same types of structure, namely enarthro- 
sis, arthrodia, and ginglymus. So too it is of no relevance to symphysis 
that bones either are joined by means of another body or by none. 136 
For while he identified three categories of such bodies by whose 
aid or intervention bones are built together—cartilage, muscle, and 
ligament—calling three species of juncture by their own names, we 
can give the name of symphysis to no joint which we would truly say 
comes together by means of a ligament or muscle. 

135 Vesalius’ taxonomy of joints is presented by a diagram in Fabrica I ch. 4. 

136 Cf. Fabrica I ch. 4: “I have also departed further from Galen’s opinion in saying that 
all attachments of bones are either aided by some substance, or by none; Galen 
attributed this only to symphysis in De ossibus , and he counted synneurosis, sys- 
sarcosis, and synchondrosis only as types of symphysis. His own account gave me 
the first reason for not following him, where he taught that soft, spongy bones are 
attached to each other by symphysis with nothing in between, but drier and denser 
bones come together by means of intermediate materials.” 

It is no surprise that while this explanation of attachment applies 
to all bone structures in which we easily see sutures and harmonies 
and which in advanced age form symphyses by means only of struc¬ 
ture and attachment and are attached without the aid of a third body, 
actual joints are held together by ligaments laid upon the bones, going 
around them, and often becoming involved by actual attachment; they 
are then held in place by muscles (which are considered as flesh). 
In younger people we see cartilage quite handsomely come together 
into a symphysis. 

When it comes to mind that Galen in talking about symphysis 
wrote that spongy, soft bones are attached with no intervening sub¬ 
stance while drier, denser bones coalesce with something interme¬ 
diate, we nevertheless see, as I recently said, that in children, whose 
bones are spongy and soft, symphyses are formed through the medium 
of cartilage while in the elderly, whose bones have become arid, dry, 
and more dense, such cartilage has altogether disappeared; indeed, not 
even a line of attachment generally appears. 

As Galen had little thought of types of bone attachments or 
constructions, so too he appears skimpy in providing examples with 
which to confirm his joints. Yet when examples are cited of the types 
of joints known to him, errors are not altogether missing. 

He shows himself to be not much of an anatomist when he 
groups vertebrae with ginglymus and thoughtlessly states that the 
highest and the middle vertebrae are attached by ginglymus because 
they both support and are supported, not considering that this distinc¬ 
tion exists in various joints and that he cites three bones to explain 
the composition of ginglymus. For although all the vertebrae that 
there are up to the first cervical vertebra above the twelfth thoracic 
(or whichever one there is received on both sides) He beneath a ver¬ 
tebra on their upper surface, they also admit one that is placed under 
their lower surface. Those in turn that are in the loins are articulated 
in the opposite way; but in the articulation of two vertebrae to each 
other, a mutual entry does not arise, and for that reason neither is 

there a ginglymus. Though one might wish therefore for a bone to 
be attached by ginglymus because it admits a bone on its upper side 
but another enters on its lower side, or conversely it receives on its 
lower side and is inserted on its upper, a person who has no system 
for the composition of a joint and does not observe how many bones 
he is bringing to one example or one construction will pile up no 
small number of bones, such as the first digital bone, as being joined 
by ginglymus, and like Galen will make quite conflicting statements, 
since the types of joint must always be applied to the attachment of 
two bones. 

But we shall set these aside and move on to specific descrip¬ 
tions of bones. The bone of the head numbered eighth [os ethmoi- 
dale\ comes to mind, placed at the base of the frontal bone, which 
I am surprised Galen did not surround with his peculiar sutures. I 
wonder why he thought it pervious more like a sponge than a sieve, 
since its foramina are more comparable to a sieve, and they were 
not provided specifically for the dripping of cerebral phlegm, since 
phlegm could not be taken this way without disease. But this opin¬ 
ion of Galen should better be considered in the bone resembling 
a wedge [os sphenoidale], which presents the appearance given to a 
sponge and is constructed below the base of the cerebrum with var¬ 
ious foramina that do not penetrate directly, like those of a sponge 
or rough pumice. Galen’s view, however, is false, and the entire sur¬ 
face visible in the space of the skull appears smooth (except for the 
sinus and its processes), and is formed whole no less than the bone 
of the forehead, the temples, or the occiput, not of a crust pierced in 
the manner of a sponge. 

It is definitely a surprise that Galen imagined such a construction 
to be for the purpose of straining phlegm, which would have been a 
very poor design, and that he should not instead have discovered the 
hollows which occur with great frequency in that bone at the place 
where it needed to be thick, among other reasons for the sinus where 
the gland [hypophysis (glandula pituitaria)] is contained that receives 

cerebral phlegm and is everywhere joined to such elegant processes 
that are no less important to observe than the sinus itself. 

Indeed, from the variable and noteworthy composition that 
occurs in the cavity of the skull, namely the many depressions and 
protrusions made for the greatest usefulness by the supreme Creator of 
things with signal foresight, I conclude that Galen considered nothing 
because he mentioned none of them and wrote nothing of the things 
appearing there; perhaps someone would argue that he mentioned the 
bone that is observed located in the cerebrum. 1 ’ It appears that Galen 
found some mention of such bone among the professors of dissection, 
and to avoid seeming to have overlooked or omitted anything said by 
others, mentioned that also very much in passing. 

For my part I find that the human cerebrum has no bone; I 
first learned of one in dogs, from which talk of this bone made its 
way to anatomists. In dogs, a large, wide, but thin bone [tentorium cer- 
ebelli osseum] stands between the cerebrum and the cerebellum along 
the lower hollow swelling of the cerebellum, convex superiorly for 
the cerebral concavity and brought forth from the occipital bone to 
which it is completely continuous. It can be deduced that anatomists 
attributed this bone to certain animals, and that Galen, though it was 
not clear to him what it was, mentioned it. 

It is the same with the bone that Galen imagined from 
Hippocrates is in addition to the acromion and the clavicle and is the 
third in that joint. 138 

There is no account in Galen of the cavity [cavitas tympanica] 
carved out in the temporal bone for the organ of hearing. But it is 
so complex and elegant and attests the craftsmanship of the supreme 
Maker to the highest degree, if anything does. 

137 See “A bone inside the canine skull” in Fabrica I ch. 6. 

138 In De ossibus 766.9—12 Galen described the diarthrosis of the acromion and clavicle: 
“Some anatomists call this combination acromion, but others maintain that besides 
these two conjoined bones there is a third bone, found only in man, which they 
also call katakleis or acromion” (tr. Singer 1952, §775). 

Z Z 9 


The tympanic cavity in the 
temporal bone as illustrated 
in Fabrica I ch. 8 with the 
two auditory ossicles that 
Vesalius knew: the malleus 
(L, M) and the incus (I, N, 
O). In P, Q they are shown 
as joined in the ear. 

As that cavity escaped his notice, so too it is learned that he had 
no knowledge of its membranes and of the ossicles, one of which we 
compare to a femoral bone without its lower heads or to a hammer; 
we have said the other is like an anvil or a molar with two roots. 

In enumerating the roots of teeth, Galen is not entirely accurate: 
the innermost and last molars have shorter, more compact, and often 
fewer roots than those that come next to them in order. So too the 
molars next to the canine teeth do not have as many roots as Galen 
attributed to them. As he gave slight attention to the roots, so too he 
neglected the cavity that is handsomely visible in each of the teeth. 1 
It is not so surprising, however, that Galen passed over the dental cav¬ 
ity that must otherwise receive much attention when they decay, for 
he went so far in denying there are hollows in the small bones as to say 
that the digital bones are solid, though that is not consistent with the 
truth.They have the same structure as the femur or the humerus in the 
hollow extended along their length, the receptacle of the marrow. 

In his account of the foramina of the head, among other things 
he wrote inaccurately that the foramen providing a path for the optic 
nerve is twice as large as the one that transmits the nerve of the sec¬ 
ond pair. 140 

139 These criticisms of Galen are not present in the Fabrica , where much of what is said 
in Bk. I ch. 11 regarding the shape and arrangement of teeth is paraphrased from 
Book 11 of Galen’s De usu partium, beginning at 3.868.19 (May 1968, 516ff.). 

140 N. oculomotorius, in modern anatomy the third cranial nerve. 


In writing that, he was no doubt thinking only of the nerves. If 
he had undertaken a careful dissection of this place in man, he would 
have learned that not only the nerve of the second pair but also a por¬ 
tion of the third, which we know is directed to the eye socket, is 
borne through that foramen. Moreover, he would have learned that a 
large portion of cerebral phlegm is taken this way, and that it provides 
a way for the vein extending from the eye socket into the hard cere¬ 
bral membrane as well as for the large artery leaving the skull cavity, 
and therefore that this foramen is justly seen to be larger than the one 
by which the optic nerve is taken. 

Just as Galen did not observe the course of phlegm, so too on 
the basis of his description of the reticular plexus 141 we have no doubt 
that he believed no arterial offshoot is borne to the eyes from the skull 
cavity; since something of the carotid artery enters the head, Galen 
contends it is taken into this plexus, from which in turn two branches 
emerge as large as the carotid artery was when it entered the skull. It 
will be explained later how absurd these statements are. Now I must 
confine my account for a time to the subject of bones. 

Galen mentions few foramina from a very large number, and he 
describes them with little accuracy. Such is the foramen by which he 
says the carotid artery is taken with the third pair of cerebral nerves. 
The fact is that the artery has its own elegant foramen that deserves 
the greatest attention. How the foramina of the remaining arteries 
entering the skull escaped his notice can be known from the arteries 
of which he is seen to have known none except the carotid artery 
presented to his reticular plexus. 

In his description of the upper maxilla, one cannot agree with 
Galen. He imagines it is solid, lacking in marrow, and light in weight 

141 On the mythic Galenic rete mirabile or retiform plexus, see Fabrica III ch. 14, “What 
is Galen’s reticular plexus?” Even Jacob Sylvius (In Hippocratis et Galeni physiologiae 
anatomicam isagoge, written about the same time as Vesalius’ Fabrica) acknowledged 
its absence in humans but implied that human anatomy had changed since Galen: 
it “still appears today in brutes” (fol. 57r). 




because it is not moved like the lower maxilla; for besides the foram¬ 
ina of the nostrils, which are so large and spreading, large cavities 
mostly filled with air are seen, and for this reason the maxilla is very 
light, in more or less the same way that we know images are cast in 
hollow molds and hung in churches to the saints: when eyes are hung 
upon St. Lucy, the breasts and chest upon St. Agatha, and arms and legs 
upon St. Anthony. 142 + 

So if one were to think about the constitution of the mouth, 
the series of teeth in the upper maxilla, and the seat of the eyes, and 
therefore know this bone is not small, he will certainly praise Nature, 
because she did not burden man unnecessarily but at the same time 
wisely provided for its strength and light weight (which otherwise 
would have consisted in bulk). 

Mention was made earlier of sutures because those that are seen 
in simians and dogs are not seen in humans. However, it was also well 
enough indicated at the time that their course was not quite rightly 
described by Galen even in simians. In certain other sutures the course 
is so unclear that we learn he described one and the same suture as 
seen in different places with the name of three sutures. 

I do not understand why Galen said that the hyoid bone is not 
constructed of many different ossicles. 143 

142 In Fabrica I ch. 9 Vesalius says “The [upper maxilla] makes up most of the sides and 
lower area of the nostrils, and near these sides it is quite hollow and not at all solid, 
but rather elegantly like waxen images that are hollow inside” — perhaps a muddled 
reference to figurines crafted by the lost wax technique. Saint Lucy is the patron 
saint of the blind; Saint Agatha is (inter alia) the patron of wet nurses and was often 
depicted carrying her breasts on a plate; Saint Anthony of Padua was the patron of 
lost and stolen things. 

143 Though the human hyoid bone is composed of five ossicles before they fuse in later 
life, Vesalius’ illustrations of the hyoid bone in Fabrica I ch. 13 are more typically 
animal than human.Vesalius is described as using “the larynx of an ox and of some 
other animals” in a 1540 anatomy lecture at Bologna “because, he said, in the 
hanged [human] subjects we cannot see the larynxes, for they are destroyed by the 
noose, but they are however quite different [in man and in animals].” (Eriksson 


In the same way, in the joining of the thoracic vertebrae at their 
bodies, I see that the body of no vertebra is formed on its lower side 
like the cervical vertebrae or received by a concave upper side of the 
vertebra below it, though that was the view of Galen. 144 The thoracic 
vertebrae are joined with straight, level surfaces in the structure of 
their bodies no less than the lumbar. 

In a not altogether different way, he stated that all the sinuses of 
the transverse processes of the thoracic vertebrae by which the sec¬ 
ond attachment of the ribs is accomplished face downward. But the 
processes of the lower vertebrae to which the ribs are joined in their 
second attachment have their sinus facing handsomely upward no less 
than the sinus of the higher vertebrae inclines downward. Similarly 
the middle vertebrae have the sinuses in their transverse processes 
inclining neither up nor down. 

It is read more than once in Galen that all the ribs are joined to 
the vertebrae by two attachments: one to their body and the other to 
their transverse process, but that the tenth vertebra and the two lying 
immediately below it are without transverse processes. 145 The tenth 
rib is attached by two connections, so it is clear that the tenth verte¬ 
bra does not lack transverse processes. However, the two ribs below 
this one are quite small and travel transversely and very slightly for¬ 
ward at an angle; for these reasons it was not necessary that transverse 
processes be provided for the vertebrae to which they are attached. 
Nevertheless, for the sake of muscles those vertebrae do have trans¬ 
verse processes, but they are wide and project very little. 

I have little idea what came into Galen’s mind when he thought 
that the humerus is the largest of all bones after the femur. 14 ' 1 In us, the 

144 In Fabrica I ch. 16Vesalius had faulted Galen for failing to distinguish the articula¬ 
tions of thoracic vertebrae from those of the cervical. 

145 Vesalius misrepresented Galen here and in Fabrica I ch. 16; Galen says three times in De 
usu partium 4.78—83 that only the last two thoracic vertebrae (the 11th and 12th) lack 
transverse processes. This criticism was deleted from the 1555 edition of the Fabrica. 

146 Galen De usu partium 3.121.4 (tr. May 1968, 131), where the humerus and the 
femur are called “the largest of the members.” See also De ossibus 767, where Galen 


fibula is longer than the humerus, and the tibia is seen to be not only 
longer but also thicker, at least in humans; in dogs it is somewhat less 
thick than the humerus. Moreover, the bones attached to the sides of 
the sacrum are much heavier than the humerus. 

When Galen writes about the lower end of the humerus he 
makes its inner tubercle [epicondylus medialis ] greater than its outer, 
calling it inner because it stands at the inner side of the joint of the 
ulna with the humerus and provides a beginning for many muscles 
and handsomely serves certain descending nerves. He names the outer 
tubercle [condylus humeri, capitulum humeri] the one that is placed at 
the outer side of the aforementioned joint when it articulates with 
the radius and likewise provides origins to muscles; it is many times 
greater in both thickness and power than the inner tubercle, however 
much Galen declares to the contrary. 147 

Galen’s description of the wrist’s articulation with the bones 
of the lower arm should be considered in detail by the student of 
the truth; the joint is contrived by Nature’s considerable craft, but 
Galen does not understand its construction. Indeed, he mixes in many 
things that argue the negligence of nature. Though he believed the 
entire articulation of the wrist to the radius should be reported as 
well as possible because the wrist should be moved to a prone and 
supine position with the entire hand in secondary motion by means 
of the radius, yet the ulna upon which the radius is then moved to 
a great extent supports the same motion; Nature has had the foresight 
to augment the radius beyond its usual thickness near the wrist and 
carved a long depression into it where the three upper bones of the 
wrist, adhering to each other and constructed as a single head, are 

calls the humerus “the largest bone except the femur.” (tr. Singer 1952,773).Vesalius 
corrected this in Fabrica I ch. 23. 

147 In Fabrica I ch. 23,Vesalius cited Galen De ossibus chapter 16. See 767—8:“The lower 
end [of the humerus] divides into unequal condyles. The radius diarthroses with 
the outer, but no bone engages the inner, so that it seems much larger than the 
outer, though it is but little larger.” (tr. Singer 1952, 773). 

Z 24 

articulated. This is also done while a portion of the third bone extends 
beyond the radius and rests in the ulna (though not without the aid of 
another body). 

For because the radius was 
unable to constitute the entire socket, 
it extended a cartilage on its lower 

Detail of Vesalins’ first figure in Fabrica 
I ch. 24 showing the distal end of the 
radius (on left) and the ulna (right) where 
they articulate with the carpal bones. The 
articular depression or socket is marked 
x, y. T is the articular disc, the cartilagi¬ 
nous extension of the radius as far as the 
acute (styloid) process (R) of the ulna. 

side which is smooth and slippery on its lower surface and rests 
upon the round head of the ulna as far as the inner side of its acute 
process, taking up that head of the ulna like the socket of a joint. 
This cartilage [discus articularis] originating from the radius below is 
smooth and slippery, fitting and admitting the rest of the third car¬ 
pal bone [os triquetrum] and filling in whatever was lacking from the 
radius in the depression where it was articulated to the wrist, since 
the wrist is not contiguous with the ulna to form a joint without the 
assistance of another body. A ligament comes forth from the tip of 
the acute process of the ulna, which is not covered by the aforesaid 
cartilage, in the same way as ligaments originate from the highest 
peak of the radius and the surrounding edges of the socket, attach¬ 
ing the wrist to the bones of the forearm. This tip of the ulna is not 
smooth, and makes contact with the wrist as a kind of joint. But 
it seemed otherwise to Galen, who was overly partial to the acute 
process of the ulna, and described the articulation of the wrist to 
the forearm (so far as I understand from his description) as equally 


belonging to the radius and ulna. How far that is from the plan of 
Nature is readily seen from the actual attachment of the wrist to the 
forearm as just described. 

As Galen thought only casually about this joint, so too it is no 
surprise that he did not explicate the two rather loose joints in man 
by which the radius is articulated to the ulna. The ulna admits the 
radius at the upper joint while the ulna is taken in by the radius at the 
105 lower. 148 In the same way, he neglected the cartilage that originates 
from the radius and separates the ulna from the wrist and almost hands 
over the whole wrist joint to the radius. 

But as he passed over this cartilage, he also seems to have consid¬ 
ered none of the others that in addition to cartilages attached to bones 
like a crust in smooth joints and by their softness and durability making 
the bones’joints resistant to injuries, are arrayed in certain joints just 
as I find the cartilage now mentioned between the wrist and the ulna. 
Such cartilage is smooth on each side and is attached to the articulated 
bones only by nearby ligaments. You will find such cartilages in the 
articulations of the lower jaw to the upper, and in the attachments of 
the clavicles to the breast bone; so too in the connection of the clavicle 
to the top of the shoulder or upper process of the scapula. 

The wrist bones are not so hard and dense that they are not 
also visibly porous and filled with marrow, no less than the epiphy¬ 
ses of bones or other parts of bones located outside the large cavities. 
Though Galen wrote at length about the digital bones, he did not 
need to add that the digital bones have the same shape as the digits. 
For although the metacarpal and metatarsal bones are more or less 
round lengthwise, and can be compared to the digits in that way any¬ 
where, nevertheless as the digital bones appear convex and rounded 
externally, so too they are compressed internally and smooth in such a 

148 As printed in both Basel and Venice editions, superiori quidem articulo radius ulnam 
excipit, inferiori autem radius ulnam admittit, the text is garbled and is corrected in our 
translation based upon whatVesahus wrote in Fabrica I ch. 24 (p. 113): supra ... ulna 
radium excipit, infra vero a radio ulna excipitur. 


way that with the tendons attached to their inner side (which are like 
half of a smoothly rounded shape) are only rounded. 

I also do not know whether it was Galen’s opinion as he wrote 
it, that all the digital joints are alike and the internode of the previ¬ 
ous bone simply enters the socket of the bone that comes next, just 
as if he wished it said that the attachment of digits is accomplished 
by enarthrosis. There is in fact a large difference in the joints of the 
digits. As their motion is also variant and distinct, Nature’s great fore¬ 
sight is provided to them. We flex and extend the first internodes 
of the four digits, and we move each one to the sides.The second and 
third internodes experience only extension and flexion and have no 
common share with lateral motion. It was sufficient for the separation 
and adduction of the digits that the first joints could be moved to the 
sides and the other joints would follow their movement by secondary 
motion. Meanwhile provision was made for their strength by a more 
powerful type of articulation. For we know that ginglymus is less 
prone to dislocation than enarthrosis, and the first digital joints are 
joined in this way, while the second and third joints, as I have written 
at length, 149 are constructed by ginglymus. 

I am therefore surprised at Galen because in De usu partium he 
attributed insertion of muscles moving the digits laterally only to 
those bones that are moved to the side by their own motion, just as 
the Ancients had believed, whose opinion he probably used in writing 
that work. But in De anatomicis administrationibus he gives evidence of 
poorly observed muscle insertions when he says these insertions are 
made in all the joints of the digits, no doubt confused by the tendons 
that are attached to the outer side of the digits from the muscles 
which in various combinations are responsible for their extension and 
abduction to the side away from the thumb. 


See Fabrica I ch. 27, “The form of the first, second, and third joints of the four 
fingers” (p. 124). 


But someone could justly argue that this has more to do with 
the traction of muscles than of bones. Of the great number of ossicles 
that have gotten their name from the sesame seed which I have men¬ 
tioned in my work, I cannot be sufficiently amazed that Galen clearly 
explained the location of scarcely a one, and passed them over no 
differently than if he had found none or very few while dissecting, as 
they tend to be removed along with ligaments or tendons. 

When Galen considered the sockets of the tibia in which the 
lower heads of the femur are received and stated that they are hollowed 
out in proportion to the heads, it is surprising he did not notice how 
casually and shallowly Nature carved out those sockets if they are to 
be compared with the large, protuberant heads of the femur; in the 
process she prepared certain cartilages as a rare and singular benefit 
and not without good reason, greatly increasing the capacity of the 
sockets. Galen appears in his examination of the knee joint not to have 
observed those cartilages, which are smooth above and below and are 
placed like a crescent moon around the sockets: thick on the outside 
and gradually ending in a kind of edge, by this means handsomely 
making the sockets deeper, as I explained carefully in the first book of 
De humani corporis fabrica. 151 ' I also stated there that the patella seemed 
harder and of a different constitution than I thought fitting for others 
to have assigned the name of a cartilaginous bone. 1 ’ 1 

I was also unable there to pass over the long-winded comparison, 
in the third book of De usu partium, of the human foot with the feet of 
other animals, where I could in no way agree with Galen: he attrib¬ 
uted the longest foot to man, but I said it was the shortest, if by the 
word “foot” should be understood that which is mostly comparable 
in the human foot to similar bones in number, shape, joints, muscles, 

150 Vesalius mentions this omission of Galen first in Fabrica I ch. 2 (p. 4), and adds that 
these cartilages (the lateral and medial meniscus) “were better known to the Arabs.” 
He details their structure in ch. 31 (pp. 138—19). 

151 See Fabrica I ch. 32 in the section titled “The substance of the patella” (p. 142). 


tendons, and other things of the sort that we consider in describing 
the parts. Cats, dogs, my weasels, squirrels, hares, rabbits, wolves, Hons, 
and especially simians have the heel bone, talus, navicular bone, and 
four bones of the tarsus distinguishable from human bones with very 
few differences. After these comes the metatarsus and the toes, and 
the proportion of muscles is great. We therefore need to call the body 
formed of all these the foot and compare it to the human foot. The 
foot of quadrupeds begins where Aristotle and where Galen in the 
third book of De usu partium established the joint comparable to the 
human knee, where they placed the talus in animals with cloven 108 
feet. 17,2 But the talus of the horse, the ass, and any animal with a single 
hoof also occurs where it does in cloven-footed animals. In quadru¬ 
peds having feet divided into toes, the talus is also in the same place, 
like the talus in man and comparable in use to the talus that cloven¬ 
footed animals present to view though they do not correspond very 
much to each other in appearance. 

So it is that the foot of four-footed animals begins from that 
joint;' 3 ' how much it exceeds the human foot in length when com¬ 
pared with it, is most evident to everyone who is unwilling because of 
an unduly stubborn devotion that we have for authors to deceive their 
own reason. I know how many opinions of Aristotle fail as a result 
of this observation as soon as one learns from me that the femur in 
quadrupeds is proportional to ours; it is articulated by its round head 
with the hip bone and attached by two heads to the tibia. Quadrupeds 
have their tibia articulated to the femur just as in man, and the patella 
placed in front of that joint as in the human knee. But the femur with 
its hip joint as well as the knee are seen in certain animals to lie hidden 
in the trunk of the body. That is probably how Aristotle went wrong 
here (as I try to show elsewhere concerning the legs of birds). 

152 Specific references are given in Fabrica I ch. 4 (p. 15). See Galen De usu partium 
3.179.11, Aristotle De incessu animalium 711a. 

153 Viz. the ankle joint or the joint containing the talus. 


In all quadrupeds the tibia is articulated with the talus, beneath 
which is the heel bone in all of them. The joint here has no other 
motion than we know it performs in man, flexion and extension. In 
animals whose foot separates into toes, everything having to do with 
the movement and succession of bones (but not the number from 
the sides) comes after this joint, more or less as it does in humans. In 
animals with a single or cloven hoof, though the series of bones is not 
the same as in humans, nevertheless whatever joints come after the 
109 talus all the way to the toenails have the same motion (so to speak) 
as the joints of human feet in flexion and extension. 

In the front feet of quadrupeds, where Aristotle and Galen (in 
the third book of De usu partium) say there is a joint which they would 
have differ from our elbow, and declare there is a difference between 
man and quadrupeds, this joint is like the one we have between the 
carpus and forearm, corresponding in motion and more or less in for¬ 
mation.This is the joint by which the radius of quadrupeds is attached 
to their carpus. The elbow joint is situated higher; in flexion, exten¬ 
sion, and the form of the articulation it corresponds to the joint of 
the ulna to the humerus in humans. The humerus of quadrupeds also 
makes an articulation with the scapula that is the same as ours. 

In the fingers and other bones of the hands, all are the same so 
far as we can compare motion. How much these observations con¬ 
flict with Galen, Aristotle, and everyone who has written often about 
the locomotion of animals and the erection, sitting, the motion of 
ankles, and many such things in humans, and how much my state¬ 
ments overthrow their opinions may easily be pondered by anyone 
who has now been alerted and is held by a desire to know the truth. 
I do not need to set them forth in detail and at length; I have under¬ 
taken only to bring to light a few inaccurate descriptions and obser¬ 
vations of Galen. It is surprising that he was so busy making fun of 
Euripides 154 that he agreed with the opinion of Aristotle. It is certain 

154 The point is that humans do in fact sometimes have bone structures like those of 
horses. In his chapter on the bones of the foot in Fabrica I ch. 33,Vesalius wrote “So 


that Galen dissected the feet of simians at least and therefore, to men¬ 
tion nothing else, he should have observed that the ape’s foot is much 
longer than man’s. 

But now an end must be put to my remarks about bones, if I 
previously stated that Galen was forgetful about the construction 
of the foot and did not notice that it has one bone fewer than the 
hand: in the second book of his commentaries on Hippocrates’ 
book Defracturis he records the same number of bones in the hand 
and the foot, not considering that he counted the cubelike bone 
[os cuboideum ] resembling a die twice. First he counted it as a 
peculiar bone like the heelbone, the talus, and the navicular, and 
he has this cuboid bone as one of four that make up the upper set 
of carpal bones. After that he compares the four tarsal bones to the 
four lower bones of the carpus, not bearing in mind that the fourth 
and outermost bone of the tarsus is the one that we say resembles 
the cube or die. 

Several inaccurate descriptions taken from the account 
of muscles and ligaments 

The definition of a muscle as it appears expertly and handsomely 
was established by Galen for a person not performing a dissection or 
who is casually thinking about the nature of muscles. I was not able 

profusely does [Galen] distinguish man from the other animals in the composition 
of the bones, and so much trouble does he take to reason why man stands erect and 
sits, being more occupied in making fun of Euripides than in looking at bones.”The 
reference to Euripides (instead of Pindar) is an error by Vesalius. The reference is 
probably to a passage near the beginning of the third Book of Galen’s De usu partium 
(3.169.15 ff.), where the author comments on Pindars belief in the myth of the 
centaurs: “But we who are concerned with truth rather than legends know well that 
the substance of a man is utterly unable to mingle with that of a horse.” See Pindar s 
Second Pythian Ode, 44—8. By the time he published the 1555 edition of the Fabrica 
Vesalius corrected his error. 



to support that definition, and have had to establish 
another, which is in the second book of my work De 
humani corporis fabrica. 

Sample muscle from the beginning of Fabrica II ch. 2. 
Between 0 and Q is a nerve segment (A) from which a twig 
(B) innervates the muscle. C is the muscle’s origin, G its 
insertion as a tendon. The belly is labeled E. 

I have so far observed no muscle in the entire 
body for which Galen’s description is perfectly ade¬ 
quate to fit the nature equally well of both ligament 
and nerve, or to set some exact distinction between 
a nerve and a ligament. 1 "" This is not to say that an 
equal portion of ligament and nerve can not enter the 
makeup of muscles. Though Galen is seen to indicate 
that more often, he elsewhere judges that a portion 
of nerve is less than a ligament. The fact that a muscle 
is not intermediate by nature, or the tendon inserted 
in the back of the heel, will prove what is by itself 
much thicker than the roots of four sinews distributed 
into the femur if one imagines them to have com¬ 
bined into one body. 

How many other tendons are there, I ask, which 
are inserted into the tibia, the fibula, and the bones of 

155 The context requires that we understand “tendon” for nervus in 
these paragraphs. In the Latin, medium quid inter nervum & ligamentum 
must mean a medium of distinction between tendon and ligament. 
Lat. nervus can mean sinew, muscle, tendon, or nerve. Similarly Gk. 
vsOpov can mean sinew or tendon and the pi. vsOpa can mean nerves 
as organs of sensation. The English expression “strain every nerve” 
preserves the ancient ambiguity. The resulting confusion adds no small obscurity to 
these paragraphs, where nervus can also be a ligament but nervosus regularly means 
“sinewy.” In modern anatomy a ligament connects bones or supports viscera, while 
a tendon connects a muscle to its origin or insertion. 


the foot, having been brought from the muscles to which it is known 
the animal force 156 is borne from those four roots? And when Galen 
applies a nerve to the ligament in the origin of a muscle so that they 
may be blended together, he believes both are divided into branches; 
separated in turn into several, they eventually join gradually into one 
and make up a tendon. Who has not noticed that such a nerve com¬ 
bination cannot be made from muscles that at their beginning are 
wider than a tendon, and do not show their fibers more scattered 111 
anywhere than at their origin? The muscles responsible for motions 
of the femur that originate from the iliac bone are of the same type, 
in addition to many movers of the humerus. The intercostal muscles 
are no less wide at their insertion than in their origin, and through¬ 
out their course. The muscles that we call the transverse and oblique 
abdominals are wider where they become tendinous than at their 
origins and beginnings. 

I need not mention that nerves sometimes form a series that is 
nearly identical with the veins and arteries in the muscles, and some¬ 
times above the muscles when these are small and thin. And if you 
study this series you will sometimes observe that a nerve runs to the 
muscle far from the muscle’s head, without doubt for the beginnings 
of the muscle. For it is clear enough that nerves are presented to the 
heads of muscles that I have said are in charge of movements of the 
femur and humerus, but not in the way that Galen indicated, since 
Nature did not fail to prevent entries of nerves in a direction contrary 
to the course of a muscle’s contraction and movement. 

Again, if you compare a boiled tendon with a nerve [ligament] 
cooked at the same time and cut both transversely, you will discover 
that the tendon differs from the ligament in density, continuity, and 
substance; but the nerve [ligament] will look like a cord formed from 

156 Vesalius’ animalis vis or animalis spiritus, Galen’s psychic pneuma, was thought to be 
produced in the brain and sent through the invisible lumen of the nerves, respon¬ 
sible for motion and sensation. 



several strands and resembles the tendon in neither form nor sub¬ 
stance. The tendons of muscles are not thicker because of the blending 
of nerves with their heads or origins as Galen thought where he tried 
to show the blending in of nerves. 

I will not discuss muscles that originate with a fleshy beginning; 
they have an origin nearly three times larger than their insertion, as 
are nearly all that are responsible for motions of the femur. Let us 
consider muscles that are brought forth more or less sinewy and do 
not immediately become fleshy. Let us then see whether the first, sec¬ 
ond, or fourth muscles moving the foot make up the greater part of a 
sinewy origin than the tendon of all of them, inserted in the heel, 
has a thickness. And who does not see more fibers and sinewy origins 
in the muscle raising the arm than are seen at its insertion into the 

It should also be surprising that Galen more than once says that 
no muscles moving bones are without tendons, though in many bones 
it is otherwise. For example, there are no tendons on the intercostal 
muscles, nor in the quadrangular muscle pulling the scapula toward 
the back, the muscle adducting the thumb to the index finger, the 
lesser of the muscles flexing the first bone of the thumb, and many of 
this kind.Though one may on rare occasions have observed the nature 
of a tendon as I have described it, and reflected that flesh not only was 
created for separation of the fibers in the muscles as Galen believes, 
but must be considered the principal substance of the muscle, he will 
certainly have no difficulty understanding that the Maker of things 
first gave tendons to muscles when the muscles occupied a place along 
whose length they could not anywhere be made of flesh. When they 
are contained in a narrow place and are not extended in length, they 
have no tendons, or they have long or short tendons according to 
their location. 

There is a similar place where Galen states a number of times 
that no muscle originates except from a bone. He should have 
noticed at that time that the eye muscles do not originate from bones, 


especially the one 11,7 surrounded by the first six muscles. Moreover, 
the muscles adducting the four digits of the hand to the thumb take 
their beginning from the membranes that wrap the tendons flexing 
the third bones of those fingers. The round muscles of the anus and 
the neck of the bladder also 
do not start from a bone. 

In this detail from the fifth figure 
in Fabrica II, the triangular pec- 
tor alis minor muscle is labeled F. 
Two of its origins on the rib cage 
are labeled i and k and its inser¬ 
tion into the scapula is marked 
1. Tire deltoid muscle, partially 
removed, is marked y. 

I am equally surprised that Galen counts eight common muscles 
of the larynx, since he describes only six. I believe he wanted to add to 
the count those that are inserted into the covering of the larynx from 
the hyoid bone and which I found move it upward, if even a slight men¬ 
tion of them had occurred in Galen and he had not said everywhere 
that the common laryngeal muscles are inserted into its first [thyroid] 
cartilage, the one resembling a shield, and that they all go there. 

I shall state elsewhere that Galen did not rightly understand the 
function of the muscle [ m. pectoralis minor] that adducts the scapula 
to the chest' 38 and is inserted into the inner process of the scapula. 


157 The retractor bulbi. But this is not a human muscle. Vesalius’ account of that muscle in 
Fabrica II ch. 11 (pp. 240—21) is based in part on Galen’s description in De usu partium 
3.792.12ff. (May 1968, 483f.). To judge from his descriptions and illustrations of the 
eye in Fabrica II ch. 11 and FabricaV II ch. 14, there is no evidence that Vesalius ever 
dissected a human eye, and violated his own cardinal rules against trusting descrip¬ 
tions found in books and basing human anatomy upon the anatomy of animals. 

158 See Fabrica II ch. 23 (p. 263): “it does not, as Galen maintains, move the arm to the 
upper chest; the fact is that it was made for the scapula to draw it to the chest, as 


He also describes it badly, not only in other areas but especially at its 
origin.Though Galen more than once says otherwise, it never takes its 
beginning from the second rib of the thorax and the three that come 
after it at the point where their cartilages are attached to the chest 
bone, or for that matter from the chest bone itself. Rather, those ribs 
provide a beginning for the present muscle before they end in carti¬ 
lages. Since Galen did not understand the origin of this muscle in apes 
or in humans, it is no surprise that he put its insertion in the shoulder 
joint, though in fact it makes its entire insertion in man into the inner 
process of the scapula. In caudate apes, where that process is extremely 
small and scarcely projects, a portion of the insertion is seen extend¬ 
ing to the ligament surrounding the shoulder joint, though because 
of this insertion the muscle cannot perform the function that Galen 
wrongly ascribes to it. 

In the description in Galen of the second muscle [m. deltoi- 
deus\ moving the arm, resembling the appearance of a A, it is seen 
that several muscles are mentioned beneath it. As the muscle which 
I consider the only one resembling a A is formed from many that lie 
upon it, so too we know that the first three that move the femur and 
take their beginning in a continuous succession from the iliac bone 
are layered on each other and mutually attached. In these descrip¬ 
tions Galen is no more truthful than he is consistent with himself in 
the thirteenth book of De usu partimn and the fifth of De anatomicis 
administrationibus , 159 However that may be, you will find no muscle 
in this place besides the one I have just mentioned. Nor do I believe 
that it receives aid from any other muscle in elevation of the arm. 

its origin, course, and the insertion of its tendon show clearer than light, particu¬ 
larly in man.”Vesalius cites Galen De anat. adm. 2.480.16: “A third muscle remains 
which becomes visible when [the pectoralis major] is removed. It, too, springs from 
the sternum, [but] at its junction with ribs 2 to 6. It is the highest that adducts the 
humerus.” (tr. Singer 1956, 122). 

159 As argued in Fabrica II ch. 23 (p. 265). See Galen De usu partium 4.135.1—5 (tr. May 
1968, 616) and De anat. adm. 2.489.14—16 (tr. Singer 1956, 126). 


For if I should assign to this place a muscle that like a part of the 
muscle occupying the hollow part of the scapula fills the hollow in 
the convexity of the scapula and the area that stands between the 
upper rib of the scapula and its spine, I would not be able to give it 
the smallest space in which to make contact with the deltoid mus¬ 
cle. So far would the scapula be from attaching to the deltoid by a 
significant connection: that is what all Galen’s descriptions are seen 
especially to lack. 

As Galen occupied himself in vain establishing other muscles 
here, so too he neglected the insertion of the deltoid muscle, which he 
said takes place directly downward into the humerus, writing that its 
insertion is like that of the muscle adducting the arm to the chest. The 
fact is that the great craft of Nature fashions a more or less transverse 
insertion that angles quite obliquely downward to the rear. From the 
motion that we make when erect, moving the arm to the forehead, 
nose, ear, and then far behind the occiput in a kind of semicircle by 
means of the deltoid muscle, it is perfectly clear how necessary it was 
that it make the insertion that I describe and is seen in dissection, and 
not the one that Galen wanted, which would be taken straight down¬ 
ward along the length of the humerus. 

These things that I have said I would hke you to learn about 
caudate apes as well as humans, for they are hke us in the present 
muscle while dogs and other animals without a clavicle are very dif¬ 
ferent. The fourth muscle [m. latissimus dorsi] moving the arm, which 
originates from tips of the vertebral spines starting with the spine 
of the sixth thoracic vertebra as far as the middle of the sacrum, is 
triangular in shape and moves the arm downward; since the base of 
the scapula is covered at its higher rib by this muscle’s lower angle, it 
makes no insertion into the scapula, nor is it attached to the muscles 
lying beneath it there beyond its entire width, though it appeared to 
Galen that this muscle was attached to the scapula with a large and 
significant grip where he invented muscles pulling the scapula 115 


The insertion is not the only thing Galen attributed wrongly to 
this muscle: he also believed it took its beginning lower down when he 
wrote that it begins where the lower of the posterior muscles moving 
the scapula takes its end. I suppose that is what he called the lower part 
of the muscle that we consider the second [m. trapezius] of the mus¬ 
cles moving the scapula and 
compare to a monk’s hood. 
This part faces downward 
more than the beginning of 
the fourth muscle moving 
the arm [m. latissimus dorsi] 

Detail of the 7th Table of 
Muscles in Fabrica II showing 
the diaphragm and its openings. 
The elongated s marks the fora¬ 
men of the vena cava; r identi¬ 
fies the hiatus oesophageus that 
admits the gullet into the abdo¬ 
men, and q is the hiatus aor- 
ticus through which the aorta 
descends along the vertebrae. 

because it has that part spread upon itself for a noteworthy interval. 

I consider the muscle [m. iliocostalis thoracis] running along the 
muscles of the back lengthwise on the thorax and taking its origin 
from the fleshy parts of the loins to be the fourth of the muscles mov¬ 
ing the human thorax. It does not consist only of fleshy parts (though 
it seemed otherwise to Galen) since it makes such handsome tendi¬ 
nous insertions into tubercles of the ribs provided for it. 

In his description of the foramina of the transverse septum, I 
am in disagreement with Galen when I attribute to the esophagus, 
the path by which food and drink are delivered into the stomach, a 


peculiar foramen separate from the area [hiatus aorticus] of the trans¬ 
verse septum where it yields to the vertebral bodies and the great 
artery on its way to the loins; Hippocrates and Galen count them as a 
single foramen and place it above the eleventh vertebra of the thorax, 
arguing that it also provides a path for the gullet. The upper orifice 
of the stomach does not stand directly opposite the twelfth thoracic 
vertebra, or even if one wishes, the eleventh. It is therefore obvious 
that the esophagus could not descend that far. For that reason it has a 
peculiar foramen [hiatus oesophageus] by which it accesses the stomach; 
this foramen is not only located above the path of the great artery, but 
it also inclines slightly to the left side of the septum as does the upper 
orifice of the stomach. 160 

Concerning the orifices of the stomach, : there will be sev¬ 
eral matters to be mentioned in what follows. For the present it will 116 
suffice to have given notice that the esophagus and offshoots of the 
sixth pair of cerebral nerves that run alongside it have a separate fora¬ 
men, as does the vena cava. My careful description of muscles moving 
the back, and the very perfunctory enumeration from Galen that is 
scarcely mentioned, easily prove Galen’s negligence regarding those 
muscles. To pass over other arguments, he missed four muscles mov¬ 
ing the back which he cut off as if they were parts of other muscles. 

He omitted two that extend from the end of the posterior part of the 
sacrum to the vertebra [12th thoracic] that is supported above and 
below, are attached to the intermediate vertebral spines, and are thin 
at their beginning and end but thick in the middle. He neglected two 
others that extend from the thoracic vertebra that we say is received 
above and below, and run to the neck; they occupy the spines of ver¬ 
tebrae along which they are stretched and are very strongly attached 
to them, being not so different from the recently mentioned muscles 
except that they are as much smaller as the thoracic vertebrae are 

160 p or more onVesalius’ critique of Galen on this point, see Fabrica II ch. 25 in the 
section titled “Foramina of the septum” (p. 291). 



more obscurely moved than the lumbar vertebrae. As soon as these 
muscles grasp their spines and pull away from each other we experi¬ 
ence motions of the back. Galen did not notice those four muscles; 
but how perfunctorily he described all the others one may learn from 
his books. 

Among the ways related to vertebral ligaments in which we may 
miss Galen’s customary diligence in dissections, not the least appears to 
me to be that he disagrees with the old experts in dissection who we 
believe from Galen’s books were thoroughly trained in the anatomy of 
bodies: he disagrees with the opinion in which they affirmed that the 
vertebral bodies are connected by the cartilage that lies between them. 
We observe between the vertebral bodies a certain mucous, soft, and 
fibrous cartilage than which I should think no other body can better 
deserve the name of cartilaginous ligament. I can think of nothing 
more certain in the whole body than that these cartilages, or rather 
cartilaginous ligaments, join together the vertebral bodies. 

I therefore wonder at the invention of Galen where besides those 
cartilaginous ligaments he says that a process of some third wrapping 
of the dorsal medulla (which is probably nothing other than the ver¬ 
tebral membrane corresponding to the one that we know covers the 
other bones as well) is brought between the vertebral bodies, and that 
this, rather than the cartilaginous ligaments, is how the vertebrae are 
joined. The third wrapping of the dorsal medulla is not unknown to 
me: but I know perfectly well that it sends no processes between the 
vertebral bodies. 

But no one who has taken the trouble to study the boiled verte¬ 
brae of a lamb, a kid, or a calf could miss Galen’s calumnies against the 
Ancients. By this means he should examine three (as I would say) sets of 
cartilage between two vertebral bodies, separated by two ossicles.There 
will then appear an epiphysis of each vertebra and a cartilage by means 
of which the epiphysis blends with the remaining bone, and finally the 
cartilage or cartilaginous ligament placed between the two epiphyses. 
Thus when you decide to separate the vertebrae from each other or 


break them apart, you will notice that they do not separate between 
the epiphyses but between the epiphysis and the remaining bone, and 
the distinction will be clearly apparent between cartilaginous ligament 
and the cartilage otherwise provided for the attachment of bones. 

When Galen tries so hard to describe the tendon concealed 
under the skin of the hand and then to explain how difficult it is to 
separate from the skin, and how it is coterminous with the skin, he 
should have considered how great a quantity of globular, rather hard 
fat comes between the skin and the tendon. As it was necessary for the 
tendons flexing the second bone of the four fingers to be inserted into 
that bone, and before their insertion they would have to be divided by 
a long slit in order to transmit tendons running to the third joint, 

Galen should also have observed that this slit or opening is not made 
above the second digital bone but before the tendons have passed 118 
the first bone. When the tendons flexing the third digital bones rest 
upon the first bone, they are not hidden; indeed, they remain perfectly 
round just as they do throughout their course, though Galen said oth¬ 
erwise, having written elsewhere (still more wrongly) that they are 
inserted in the first bone. Moreover, the tendons flexing the second 
bone [m. flexor digitorum supeificialis, tendo] are not inserted into the 
sides of those bones as Galen’s opinion holds, but he hidden and place 
themselves on each side beneath the tendon going to the third bone, 
and the parts coterminous with it on each side are implanted on the 
inner [palmar] surface of the bone. 161 

161 This disagreement with Galen is aired on p. 306 of the 1543 Fabrica in the section 
titled “Transit of the tendons of the second muscle through the tendons of the 
first,” where a marginal note cites Bk. 1 of De anat. adm.\ see 2.250.16—18: “as each 
passes over the former larger tendon, each splits in two, encircles the tendon lying 
under it, and is attached to the sides of the second phalanx.” (tr. Singer 1956, 16). 
Cf. De usu partium , where the divided slips of the superficial tendon are inserted 
into “the inner parts” (toT$ evtos gEpEcn, 3.59.10, May 1968, 97) of the head of the 
second phalanx. Modern anatomy sides with Galen against Vesalius: these slips are 
regularly described as inserted into the sides of the second phalanx. 


Although after writing Du usu partium Galen prides himself while 
writing the second book of De anatomicis administrationibus that he 
has discovered ten muscles by which the first joints of the fingers are 
flexed, he always overlooks the three that serve flexion of the thumb. 
For in addition to the muscle extended from the forearm that performs 
flexion of the third joint of the thumb, we find five that also aid flex¬ 
ion of the thumb, two of which preside over flexion of the first bone 
while three flex the second. Because Galen counts ten muscles flexing 
the first bones, we will acknowledge that two of the total were known 
to him that serve flexion of the first bone of the thumb; we make this 
guess because he did not specify the muscles’ shape, location, or nature. 
We shall therefore say that the muscles that are inserted in order as if 
on the course of the life line from the palm into the second joint of the 
thumb and are authors of its flexion according to the excellent design 
of nature, were not observed by Galen. In the same way, Galen passed 
over the peculiar tendon [m. extensor pollicis longus, tendo] inserted in 
the root of the first bone of the thumb on its posterior side and not 
climbing higher like the tendons that are provided to the outer side 
of the thumb. That tendon comes from a portion of the third origin 
119 of those that originate one after another along the length of the 
ulna, as is written in my book. This third origin is the one that we 
observe during dissection is more coterminous with the wrist, and 
which Galen wrongly said originates along the entire length of the 
ulna. Though there are about four roots of tendons to the fingers on 
the outside of the arm, we sometimes see a different series. 

I will not cite here the place where Galen adds that the four fingers 
are extended by one muscle split into four tendons, while the index and 
middle fingers are abducted sideways from the thumb by one muscle 
divided into two tendons, and the ring finger and little finger are simi¬ 
larly angled to the outside by the other tendon. For although these occur 
differently in man, they are not all arranged in the same series always. 

Fdowever, it is altogether necessary to go against the position 
of Galen when he teaches that the tendons extending the fingers are 


attached only to bones, where there are structures of joints when the 
tendons are inserted equally the whole length of the bone. Also, we 
always see that the muscle placed in the hollow of the palm that abducts 
the thumb farthest from the other fingers is not inserted in the first 
bone, however much Galen taught otherwise. It is implanted in the inner 
side of the second bone by a rather short tendon, and it is no wonder 
that Galen described its insertion that way in De anatomicis administra- 

Detail from the second Table of Muscles in 
Fabrica II showing the extensor retinaculum, the 
band-like ligament forming the roof of the carpal 
tunnel, distinguished into six parts described as 
follows: “1 marks the ligament common to the 
radius and the ulna; 2 is the ligament belonging 
to the ulna; 3, 4, 5, and 6 introduce the four 
ligaments peculiar to the radius. ’’ 

tionibus though when writing De usu partium 
he thought this muscle was the whole fleshy 
mass placed at the first bone of the thumb 
and called Venus’ mount by chiromancers; 
but we say it is made up of six muscles. 

Similar to this was the opinion of 
Galen where he thought the fleshy mass 
placed below the little finger and named 
after a mountain of the Moon 162 was only the muscle that abducts the 
little finger farthest to the outside, when in fact the muscle forming 
the greater portion of this mass flexes the first bone of the little finger 
to the outside. 

As for the insertions of tendons moving the fingers, ' these no 
obviously differ from Galen’s account, not only in some that have 

162 The hypothenar eminence, here called the lunae inons and htnae monticulus in Fabrica 
II ch. 43. 


already been mentioned but also in the implantations of those that 
move the fingers to the sides (for neither I nor the doctors who pre¬ 
ceded Galen assign such insertions to joints which do not have their 
own movement to the sides), and I cannot agree with his opinion in 
the number of insertions. 

From a painstaking study of the grooves in the epiphysis of the 
radius and inspection of the transverse ligaments at the end of the fore¬ 
arm, it is also generally admitted how much we still find lacking in Galen’s 
descriptions. Besides the fact that he recognized only four of the six and 
sometimes seven rings that occur there, he also traced a false course 
for the tendons together with inappropriate grooves and ligaments. For 
example, when describing tendons of the muscle by which he thought 
the four fingers are extended, he says they are contained within a com¬ 
mon ligament and the groove of the ulna and radius. In fact, a muscle 
occupies that groove and ligament; it is inserted principally in the little 
finger, and is held by Galen to be the author of abduction of that finger 
and the ring finger from the thumb. An elegant groove is prepared in the 
radius for that muscle, which is split into as many tendons. 

I am still more amazed that Galen did not mention the mem¬ 
brane which is tenaciously attached like muscles to the surfaces of the 
transverse ligament that face the skin, just as if muscles needed to be 
restrained by that membrane to keep them from being moved out 
of position. That is especially observed in the forearm and lower leg, 
while in the thigh (as I have written) 163 that function is performed 
only by a peculiar muscle. At this point the square muscle 164 pronating 
the radius covers the inner side of the radius and ulna: but it does not, 
as Galen teaches, come between those bones. 

The muscle [in. brachioradialis\ originating from the humerus and 
inserted in the epiphysis of the radius, causing it to supinate, is not 

163 In ch. 53, Fabrica II (p. 334, misnumbered 234): this is the w. tensor fasciae latae, 

Vesalius’ sixth muscle moving the tibia. 

164 M. pronator quadratics,Ve salius’ first of four muscles specifically moving the radius: 

Fabrica II ch. 45 (p. 315, misnumbered 215). 


the longest of all the muscles moving the forearm 165 if we compare to 
it the muscle flexing the third joints of the fingers or the one held to 
be the author of extension of the fingers, or the one that is implanted 
by the two-horned tendon into the metacarpal bones and takes its 
origin from the humerus immediately under Galen’s longest muscle. 

Galen little noticed that the inner beginning of the anterior 
muscle flexing the forearm [m. biceps brachii, caput breve ] is much wider 
than the outer, taking the shape of a rounded tendon. Not only is it 
wider, but it originates with a substance that is part fleshy and part 
tendinous, with the result that the fleshy part seemed like a separate 
muscle when I first read in Galen that the inner beginning was more 
slender than the outer. 

We do not know to what extent Galen understood the muscles 
of the penis and those that occur in the wrapping of the testicles 
and seminal vessels that comes from the peritoneum. There is never 
an actual mention of them, or of the muscles of the tongue. But if 
only because Oribasius 166 and the Arabs mentioned them I can easily 
understand that he wrote about them in the books that have been lost 
to us in the damage of the ages. 

From the muscles moving the femur as mentioned in De anato- 
micis administrationibus, I shall not attempt to augment the list of inac¬ 
curate descriptions because I can find no end of them in that work. 
I also can scarcely understand some of them therein, and I think his 
examples egregiously mendacious, except in his account of the mus¬ 
cles moving the lower leg, which I considered in both De usu partium 
and De anatomicis administrationibus when writing the 53rd chapter of 


165 As pointed out in Fabrica II ch. 45; the brachioradialis is Vesalius’ second muscle 
moving the radius. Galen had said “it is the longest not only of the muscles that 
move the radius but also of all the other muscles of the forearm.” (De usu partium 
3.113.17-19, tr. May 1968,127). 

166 Physician to the emperor Julian, Oribasius was a 4th-century compiler of Galenic 
teaching. His Collectiones medicae preserve a large number of excerpts from ancient 
writers.Through Syriac and Arabic translations he was a principal conduit of Greek 
medical learning to the Islamic world. 


Book II of De hutnani corporis fabrica. For anyone reading that chapter, 
the aforementioned list of errors will be summarized and increased 
not only in muscles omitted and overlooked, but also in the origin 
and insertion of the ones he knew and in others that were improperly 
described, in the same way as in my account of the muscles moving 
the foot and its digits. 167> k 

Vesalius’picture of the portal vein 
system from Fabrica III chapter 5. 
The liver is at the top, with off¬ 
shoots of the portal vein marked 
byfiveA’s. The main trunk of the 
portal vein is labeled B. This fig¬ 
ure of the portal system as a whole 
illustrates how well the plant met¬ 
aphor worked for Vesalius. 

I could therefore justly 
seem to you ridiculous and 
too much of a drudge if I 
thought I should give you an 
enumeration of all the mat¬ 
ters of dispute in my book, 
especially since out of what 
has been so far mentioned it 
should be apparent to anyone 
of sound mind that some¬ 
thing has been misreported 
by Galen in his description of 
muscles. Sylvius, on the other 
hand, has been objecting that 
Galen stated nothing whatever less than perfectly. 

167 Chapter 59 of Fabrica II. 


Some false descriptions gathered from the account of 
veins and arteries 

But let vis see whether nothing false or erroneous was stated by Galen 
in the other organs as well, starting with the veins. 

The beginning of the vena cava does not take place in the mid¬ 
dle of the convexity of the liver in the same form as the beginning of 
the portal vein, which we know arises even more in the back of the 
liver than the front, and faces right rather than left. We see one trunk 
in the hollow of the liver 
which we call the begin¬ 
ning of the portal vein 
because it is combined out 
of many countless branches 

The vena cava (C, D, E) embed¬ 
ded in the back of the liver, as 
illustrated in Fabrica III ch. 6 
and Book Vfig. 18. 

distributed through the liver; or more accurately, this trunk distributes 
that series of branches variously into the liver. In animals, the first of 
all is split into as many branches as there are fibers: five or six lobes 
are found, and one branch is sent equally to each of them. In man, 
whose liver is formed of a continuous and simple body, the stem of 
the portal vein is generally divided first into two branches, and these 
are soon distributed into other offshoots; those offshoots are scattered 
into countless twigs and subdivisions so they can travel everywhere 
through the lower part of the liver. 

The stem of the vena cava does not rise with a similar collec¬ 
tion of branches, but is located in the back of the liver and impresses 
a groove there where it is seen surrounded by the liver on its front 
and sides but on its posterior free from the substance of the liver, not 

14 7 


surrounded by the flesh of the liver. Thus even when placed in this 
spot the stem of the vena cava easily shows how well it agrees with 
Galen’s description regarding its position. 

However, the vena cava differs in its series of branches more than 
in its location. From the front of its stem, where it stands in the liver, 
two branches are brought forth not far from each other but separated 
transversely; these are then split into several offshoots, and when those 
offshoots have been additionally distributed into a series of count¬ 
less twigs they run off through the upper part of the liver, extending 
alongside and lying upon branches of the portal vein. 

Besides the two branches originating from the front of the stem 
of the vena cava, two or three twigs are also presented to the liver in its 
descent along the back of the liver, perhaps ten times smaller in their 
orifice than the large branches and distributed by a small, short entry 
through the substance of the liver. 

However that may be, if you gather together all the mouths of 
branches and twigs distributed from the stem of the vena cava into 
the liver, your total will certainly not come to half the volume of that 
stem: so far is it from being possible to say truthfully that the vena cava 
is made up out of those branches. 168 

These matters should not much bother the viewer in dissec¬ 
tions if he is aware that the fabric of the body is so to speak diamet¬ 
rically opposed to what Galen described when he showed the vena 
cava originating from the liver. No one can ever set aside his loy¬ 
alty and examine these matters without wondering how Galen could 
have placed such trust in his own imagination and dared to contradict 
Aristotle and other weighty authors in this part of the body, teach¬ 
ing later generations what is utterly at odds with what we observe in 

168 This recapitulates Vesalius’ refutation of Galen’s argument in De plaatis Hippocratis et 
Platonis that the liver is the source of the veins as the heart is of the arteries and the 
brain of the nerves. See Fabrica III ch. 6. 


Just as Galen’s description of the origin of the vena cava is 
quite discrepant from what we observe when dissecting, so too it 
is extremely false and unworthy of an anatomist that the beginning 
of the vena cava (as Galen wrote) forms a single stalk like the great 
artery originating from the base of the heart, and is then like the great 
artery split into two trunks, one traveling upward and the other down. 
Instead, the stalk of the vena cava in this part has nothing in common 
with the great artery. 

It travels vertically along the back of the liver just as if taken from 
the heart beneath the liver, and goes to the lower body; it also provides 
branches to the liver (as had been said) from its anterior side.The great 
artery, on the other hand, proceeds upward for a while from its begin¬ 
ning as a single stalk and is then divided into two unequal trunks, the 
larger of which turns downward and is distributed to the arteries that 
are beneath the heart, while the lesser trunk goes to the upper body. 
I never thought that Galen indicated the similitude in distribution of 
the vena cava and the great artery (except in actual function, so to 
speak), unless to oppose Aristotle 169 he had taken his argument from 
the pattern of distribution (also against what Hippocrates said where 
he taught that the vein takes a direct course) where he said the vena 
cava does not originate from the heart. How effective that argument 
is, will perhaps be indicated somewhere below. 

Here, though, it suffices to have made the point that Galen’s 
opinion is quite wrong, as is the description where he set it down 
that a single stem of the vena cava originates from the middle of the 
convexity of the liver and is then like the great artery divided into two 
trunks one of which passes beneath the liver and is presented to the 

169 For Aristotle’s axiom that the heart is the source of all blood vessels (f] Se KapSia 
tcov (pAspcov apx/)) an d the arguments defending it, see /M665bl5 ff. A fuller ver¬ 
sion ofVesalius’ argument against Galen on this point is in Fabrica III ch. 6 in the 
section titled “Galen’s arguments against Aristotle on the origin of the vena cava are 
not all divinely inspired” (p. 375, misnumbered 275). 


parts lying beneath it while the other permeates the transverse septum 
and provides nutriment to the organs above it. 

Just as he taught us a false partition of the vena cava, so too it 
is no surprise that he said the portion of the vena cava visible in the 
loins beneath the liver is much larger than the one to which the trans¬ 
verse septum provides a path, taking 

This imaginary illustration from 
Fabrica III ch. 6 shows how the vena 
cava would appear next to the heart 
according to Galen’s description: “In 
this figure I have drawn the arrange¬ 
ment of the vena cava that would inev¬ 
itably result if it were split into two 
trunks at the right side of the heart. To 
observe more precisely Galen’s argu¬ 
ment, which he repeats so often and 
uses instead of the best demonstration, 
compare the present figure with some 
of those in the sixth Book’’ (p. 375, 
misnumbered 275). 


his reasoning from the parts which each nourishes: Galen affirms that 
the trunk going lower down is larger because it must provide nour¬ 
ishment to more parts than the one that goes higher. 170 As this occa¬ 
sion is not ineffective in explaining the rationale of distribution, so too 
Galen should have considered carefully whether the part of the vena 
cava below the liver supplies nutriment to more and larger parts than the 
one that stands above it, so that he would then draw the right conclu¬ 
sion from his syllogism. It should be gathered from Galen’s reasoning 

170 See Fabrica III ch. 7 in the section titled “The part of the vena cava going through 
the transverse septum [diaphragma] is not smaller than the part below the liver.” 


from the nutrition obtained that the part of the vena cava that permeates 
the transverse septum is greater than the lower part. For the gall bladder, 
stomach, omentum, spleen, and all the intestines with the mesentery 
take nourishment from the vena cava below the liver and not a series of 
branches; only the kidneys, genitals, the other bladder, the lower part of 
the abdomen, the loins, and the legs take their nourishment from a series 
of branches. The septum itself and the entire thorax as far as the first 
lumbar vertebrae together with the upper region of the abdomen are 
nourished by the portion of the vena cava crossing the transverse septum, 
as we know from the offshoots of the azygos vein and then from the 
veins passing beneath the breastbone and descending almost to the navel. 
To these are added the arms, neck, and head, where the mass of the brain 
must be considered, and the large number of vessels going to the brain. 

Now the lung also presents itself, the largest member of the 
whole body, though it is otherwise if it lacks blood. Were it not for 
the lung, blood would not be brought into the heart, but so all the 
arteries would eventually be filled by it. Thus the greatest proportion 
must be made up of the blood which is contained in the arteries. It 
is therefore evident that the portion of the vena cava visible between 
the heart and the liver should be larger than that which Galen knew 
stands at the lumbar vertebrae. Dissection also supports this thinking if 
a person investigating these matters cuts open the vena cava lengthwise 
or at least does not in the process of dissection force more blood from 
movement of the liver or the heart or rather its septum into the part of 
the vena cava that extends to the loins than he forces into the part that 
stands in the septum. When the vena cava passes through the transverse 
septum, in the part of its course that is seen between this point and 
the heart, it presents no offshoots to the membranes that divide up the 
thorax, though Galen taught otherwise, since it does not make contact 
with those membranes; and it would have been ridiculous for such 
small twigs as they require to travel supported by no membrane. 

For this reason Nature provided the membranes chiefly with 
offshoots taking origin from those veins which run beneath the 



breastbone, and exclusively in humans from veins that run out along 
the nerves of the transverse septum from the throat to the septum. 

Moreover, in what ways shall we apply Galen’s description to 
the body, a description in which he explains the distribution of the 
vena cava to the heart, sometimes taking a kind of offshoot from it 
into the heart, sometimes explaining it in some other way that makes 
the orifice by which the vena cava is joined to the heart twice as large 
as the vein’s diameter? This is the same as if from its circumference 
where it stands beneath the heart and then from its circumference as 
you would measure it where it passes the right auricle of the heart 
you would imagine a single circumference in which we combine in 
one circle the capacity of two circumferences or circles. In this way 
the amplitudes of the vena cava above and below the auricle of the 
heart would be two circles which would make up a single circle cor¬ 
responding to the circumference of the orifice by which the vena cava 
reaches the heart. 

When Galen appears to tell in his book De venae sectione about 
the arterial vein [truncus pulmonalis] as if it came out of the vena cava, 
I do not believe he thought that it was an offshoot of the vena cava 
because he did not fail to understand otherwise that the substance of 
the arterial vein does not resemble that of the vena cava: the latter is 
composed of a single tunic and the former of a double, the inner of 
which is common to all arteries, as much as five times thicker than the 
tunic of the vena cava, though on the outside matching the thickness 
of the tunic of the vena cava. Also, the arterial vein has its own peculiar 
orifice, like that of the great artery, besides which the substance of the 
heart between the orifice of the vena cava and the beginning of the 
arterial vein is at a substantial interval, easily demonstrating that the 
arterial vein does not originate from the vena cava. 

Though Galen affirms elsewhere that two coronary veins are 
127 always found, we generally find a single one, and it is large, not as 
Galen also says elsewhere, small. Also, though Galen stated in the sev¬ 
enth book of De anatomicis administrationibus that the coronary vein 


arises from the right ventricle of the heart, I do not think he had so 
briefly considered the planning of the Maker of things in the course 
of this vein that he perceived it had left the vena cava before it left 
the right ventricle or had originated before it entered the ventricle, 
and that its origin is seen under the base of the three membranes that 
control the orifice of the vena cava. 

Sylvius bore it ill that I have written that Galen did not dissect 
humans and added separately that Galen had viewed only the outer 
veins of the arm without seeing the inner veins or those hidden deep 
in the body. I agreed; I have written a few things about the series of 
veins in the throat and the arms in the place 171 where I cited sev¬ 
eral reasons out of many why I am persuaded beyond a doubt that 
Galen had no experience in human dissections. Here I set down an 
example or two of his inaccurate descriptions, such as the origin of 
the humeral vein and the series coming from the trunk of the more 
important and larger axillary vein: in these examples one might jus¬ 
tifiably look for Galen’s diligence, no less than in certain veins of the 
legs, and especially in the cerebral vessels, where he mentions scarcely 
two of the six veins entering the skull on each side. Similarly, of the 
three arteries entering the skull he explained the distribution of only 
the one from which he thought the reticular plexus was formed. Thus 
in describing the sinuses of the hard membrane it should not seem 
strange if he believed that the chief ones acted only as veins and paid 
no attention to the arteries draining into them or leading to them, 
and did not notice that the sinuses also contain the substance of veins 
and arteries. 

Based therefore upon my description of cerebral vessels in the 
fourteenth chapter ofBookThree of De humani corporis fabrica, if it is 
ever compared with Galen’s account in the ninth book of De anatomicis 

171 Chapters 7 and 8 of Fabrica III, where Vesalius describes the beginning of the 
humeral vein and the distribution of the humeral and axillary veins in the arm. 
Vesalius’words here anticipate additions he will make to the 1555 edition, where 
his critique of Galen regarding these veins is much expanded. 



administrationibus many things will present themselves in which it will 
be quite easy to observe that Galen fell short of the true distribution 
of the veins and arteries. If I were to explain all of them, the heap of 
Galen’s untrue descriptions would grow too much. Instead, it will suf¬ 
fice to have mentioned a few examples in the distribution of vessels. 

Accepted descriptions in the account of nerves which 
are not quite true 

Granted that the opinion in Galen about the olfactory organ (to add 
something about the nerves) is inconsistent, the view that he holds 
is sounder where he says that the nervelike processes running in the 
anterior part of the brain are for the organs of smell. But the view 
that the organs of smell run from the anterior parts of the cerebral 
ventricles which end in a point or narrow place is altogether untrue. 
First, the right and left cerebral ventricles are large, wide, and not com¬ 
pressed where they are closest to the anterior part of the cerebrum and 
face forward. Second, if one measures the course of the ventricles along 
the length of the brain and then in the base of the brain, and notices 
that these processes thought to exist for the organs of smell take their 
origin more or less half way along, he will observe at the same time 
that this origin comes not from the front of these ventricles but oppo¬ 
site the middle of their length. From this it quickly becomes obvious 
how scarcely diligent Galen was in the anatomy of these organs when 
he imagines they are perforated and teaches that the cerebral ventricles 
end in their cavity to become like canals in which cerebral phlegm 
is taken to the area of the skull where these organs end and the hard 
membrane of the brain appears pervious like a sieve. These are things 
imagined by Galen, for as he inaccurately reported the beginning of 
those organs, so too he falsely described them as perforated and hollow 
no less than canals and ducts for phlegm are to be considered. 

In fact, if we carefully study the actual straining-out of phlegm 
(as it is described by me) when a person is healthy in this part and is 


not complaining of any symptom in its excretion or retention, it will 
be perfectly clear that phlegm is never borne anteriorly through these 
organs out of its own course without a symptom, any more than it 
flows posteriorly along the dorsal medulla and hence along the nerves 
into various limbs. 

I must blame my own negligence that I do not find a foramen in 
the optic nerves; perhaps they have a foramen constructed differently 
from those of other nerves which can be understood by dissection. 
Whenever I perform a dissection of live animals or inspect the nerves 
of a human head that is still hot after an execution, or warm up in 
hot water the heads of persons who have been dead for some time, I 
never find the appearance of those foramina. In pigs, however, I find 
a difference because in them the optic nerve is transversely divided, 
and when boiled is constructed as if with many strands like the nerves 
that occur in the arms and legs. The optic nerve of man, however, is 
made of a continuous substance, uniformly dense everywhere, and in 
my opinion is not pierced by an obvious foramen. I think it is due to a 
faulty copy that in the book De nervorum dissectione it is written that the 
second pair of nerves is harder than the third. I am therefore unwilling 
to fault Galen in this case because I am otherwise nowhere able to sur¬ 
mise in the absence of copies where an error has been made. 

Of the two branches running from the fifth pair of nerves when 
it is still in the cavity of the organ of hearing, toward the temporal mus¬ 
cle and branches of the third pair, mention occurs in Galen of only one. 
Likewise, he also missed the root of the nerve to the interior, which 
does not originate from the side with the fifth pair in the same way as 
what we call the lesser root of the third pair is brought forth next to 
the principal nerve (but the outer one) of the third pair. Because of 130 
this I would not add the root that I discovered to the fifth pair lest I 
disturb other anatomists’ system of numbering for its sake. ! 72 This root 

172 Cf. Fabrica IV ch. 2: “Close to the root of the fifth pair, careful dissection has taught 
me that another pair [n. abducens ] originates, unknown to all who make a study of 


travels forward beneath the base of the cerebrum, passing through the 
hard cerebral membrane and claiming for itself a special foramen in the 
skull; it is then presented to the temporal muscle and principally to the 
muscle [m. pterygoideus medialis ] concealed in the mouth. 

If after closely examining the complete construction of the cer¬ 
ebellum we believe the beginning of the dorsal medulla comes from 
the cerebrum and that the cerebellum clearly joins it only by a single 
conspicuous connection at either side of the ventricle common to 
the cerebellum and the dorsal medulla, we cannot agree with Galen, 
who provides to the cerebellum so many nerve origins that must be 
assigned to that interval of the dorsal medulla which extends from the 
base of the cerebrum to the area where the occipital bone is articu¬ 
lated to the first vertebra. 

Descriptions of the parts that are contained in the 
peritoneum, which are not entirely true 

Above (so I may write something about things contained in the peri¬ 
toneum), when I was setting forth examples of untrue descriptions in 
the muscles and mention was made of foramina in the transverse sep¬ 
tum, I was concluding from a true description of the position of the 
stomach and the meeting place of its upper orifice with the esopha¬ 
gus, that the esophagus does not use the same foramen as the great 
artery which must run along the lumbar vertebrae. At present I must 
not fail to say that Galen wrote that the esophagus is not only con¬ 
joined with the descending great artery at the place where also, in his 
opinion, this foramen of the septum stands, above the eleventh tho¬ 
racic vertebra; in addition, that the esophagus is attached to the artery 
as far as the twelfth vertebra, no differently than if the esophagus were 
first raised from the artery and the vertebrae of the back beneath the 
septum and went to the stomach by passing from right to left. Because 

dissection. I shall not, however, depart from the old numbering of cerebral nerves” 

(p. 422, misnumbered 322). 


the entire stomach is placed somewhat higher here than one would 
consider unreasonable, would the esophagus turn upward again, to be 
connected with the higher orifice of the stomach? 

Therefore reason argues no less emphatically here than dis- 131 
section that Galen accurately described neither the course of the 
esophagus nor its position. So 
far as concerns his description 
of the site of the whole stom¬ 
ach, Galen determined that 
it stands in the middle of the 
body so that he could represent 
all dimensions according to the 
mob of anatomists who are too 
casually trained in the propor¬ 
tion of man. But Galen also did 
not want to put that so glibly 
as not to state that the greater 

Anterior view of the stomach as 
shown in Fabrica Vfig. 14. A, B, C, 
and D mark the course of the esoph¬ 
agus, the slight bend of which at C 
places the bulk of the stomach toward 
the left side of the body. H locates 
the lower orifice or pylorus, which 
Vesalius emphasizes does not emerge 
from the bottom of the stomach. 

bulk of the stomach is placed on the right side of the body, as do 
all the compilers of anatomy who follow him, adding that this was 
rightly done so the stomach would be conveniently placed beneath 
the liver and kept warm by it, gaining from it an improved power of 
digestion. Surely, if we have examined the human body not in our 

15 7 

dreams and imaginations but by careful dissection and inspection, 
we shall find the much greater part of the stomach in the left side of 
the body than in the right. For if we measure the width of the stom¬ 
ach from left to right we will note that as much as two thirds of it 
occupies the left side. This is quite opportune in respect to position, 
because the spleen lies beneath the back of the stomach low on the 
left side and with its point inclines only a little forward down to the 
left side of the stomach, and easily allows the left side of the stomach 
to be coterminous to the transverse septum over a large area. On the 
other hand, the quite considerable thickness of the liver prevents the 
right part of the stomach from coming into contact with the sep¬ 
tum either on its side or its posterior surface or to a large extent its 
anterior, and it easily ensures that the right side of the body does not 
provide space for the stomach as the left side does. 

Again, if we consider the true shape of the stomach and observe 
contrary to others’ descriptions that it is not equally large along 
its entire width which I was measuring a httle earher from left to 
132 right, we will see that because of its shape the stomach fills the left 
side of the body more. This is because the stomach is quite large and 
swollen on its left side, allowing for all differences of position, and the 
more it is moved to the right the more it is forced into a narrow space, 
and is seen much more constricted there and narrower. If one drew 
circles around the two sides, the one around the right side would look 
twice as small as the one making a circuit of the left. 

I do not know whether in describing the shape and position of 
the stomach I should not have Galen consistently in the number of 
those who set the lower orifice of the stomach in its lower side: I have 
to this day found no one who rejects that opinion. I also say that noth¬ 
ing has been observed about the site of the stomach’s orifices except 
that they are not opposite each other, or they are not both fashioned 
in the left side of the stomach; though in fact the orifice that we call 
the lower, the beginning of the intestines, is not at the bottom of the 
right side but at its highest point; and though the lower orifice is 


brought out of the stomach like an intestine, it rises a little before it 
curves along the back of the stomach. This must be examined with¬ 
out haste, in view of a great many problems about digestion in the 
stomach, the order of foods, and vomit, as these have now begun to 
be brought into dispute. 

To this controversy belongs the opinion by which the fundus of 
the stomach 1 ' is considered fleshy, just as if its lower part along the 
width of the body were quite fleshy and thick, and altogether differ¬ 
ent from its upper region. I am able to imagine no difference, unless I 
were to decide that the area closest to the upper orifice is quite fleshy, 
not only because of a large number of nerves but also because of the 
quantity of veins and arteries occurring there, and because it is coter¬ 
minous to the esophagus, which is otherwise more fleshy than the 
entire stomach. However, neither color nor substance suggest that 
anything more fleshy be credited to the fundus. 

I am quite surprised that when Galen examined the glandu¬ 
lar body [caput pancreatis] extended toward the duodenum and wrote 
incorrectly that it was responsible for closing the lower orifice of the 
stomach, he did not think about the substance of the stomach in its 
orifices, where it is much thicker than in the rest of the stomach cav¬ 
ity, as if showing one circle protruding inward in each of its orifices 
which is seen to shut off the stomach from the esophagus and the 
intestines, bringing no slight toughness to the stomach and making it 
resistant to injuries if some rough, larger body should ever be brought 
to its openings. 

If any vein offshoots are presented to the stomach from the vena 
cava, as Galen asserts in De anatomicis administrationibus that some are 
taken from there where it lies beneath the stomach, I gladly admit my 
ignorance, as I have so far discovered none. I also believe the reason is 
that no vein is distributed to the stomach except offshoots of the portal 


173 The fundus gastricus, above and to the left of the entrance of the esophagus and 
thus its highest point. 



vein. I am also such a newcomer to thought that I have never to this 
day believed the popular notion anything but pure fable that origi¬ 
nated somewhere or another, according to which it is claimed that the 
esophagus is narrower where it connects to the stomach than in the 
rest of its course through the neck or the thorax because of the black, 
melancholic blood or juice which is belched up here from the spleen, 
and that the upper mouth of the stomach collects it and cuts it off. 174 

However, that has more to do with the use of the parts than the 
reason for their form. An example is the location of the omentum, 
which I find explained the same way by everyone: 1 '" they write that 
the front of the stomach is covered by it so that if cut away from the 
stomach and the intestines it would result in their weakness. But if 
trust is to be placed in dissection, the upper membrane of the omen¬ 
tum is attached like a suture to the lowest part and bottom of the 
stomach, : or rather it takes its beginning from there, nowhere lying 
upon the front of the stomach. 

A similar case is the account given by those people of the colon: 
they say it covers the front of the stomach, writing that the colon rides 
upon the stomach, when in fact the colon is extended only along the 
lower region of the stomach, nowhere rising to the front higher than 
the stomach. Just as Galen wrote that some offshoots are presented to 

174 Having cut the ground from under the ancient doctrine presuming that a mythical 
black bile originating from the spleen is transported into the stomach,Vesalius does 
not pause to reflect upon its impact on humoral theories of character. 

175 See for example Alessandro Achillini’s Annotationes Anatomicae (1520): “The heart is 
above it with the diaphragm between; below are the mesentery and the intestines, 
on the right the liver, on the left the spleen, in front the omentum.” (tr. Lind 1975, 
46); Alessandro Benedetti’s Anatomice (ca. 1497) ch. 10: “The omentum protects 
[the stomach] in the anterior region.” (tr. Lind 1975, 93); and Niccolo Massa’s Liber 
introductorius (1536) ch. 14: “Around the middle of the stomach, going lower, is the 
origin of the omentum or zirbus.” (tr. Lind 1975, 193). This idea can be traced to 
Aristotle Historia Animalium 495b29: “The omentum is attached to the middle of 
the stomach” (Loeb tr. by A. L. Peck) .Vesalius took issue with these views at the end 
of FabricaV ch. 3 in the section titled “No part of the omentum covers the front of 
the stomach” (p. 494). 


the stomach from the vena cava, he also testified that certain offshoots 
are propagated from the vena cava into the omentum, in addition 
to the branches from the vena cava that implicate it in numerous 
ways; he likewise put it about that other veins are provided by the 
vena cava to the mesentery and intestines.This opinion occurs in the 
sixth book of De anatomids administrationibus, where it is also read that 
veins reach into the mesentery that did not end at the liver. On the 
other hand, he argues that no vein unconnected to the liver is found 
in the body (however that may be true), disagreeing with Aristotle 
De venarutn ortu. Furthermore, I believe that by that limit he distin¬ 
guished offshoots coming from the vena cava from those which are 
implanted from the portal vein into the intestines and bring to the 
liver the juice which is the material of blood. However, I have seen no 
twig distributed from the vena cava into the omentum, the mesen¬ 
tery, or the intestines; I regularly advise students of this fact when after 
the stomach, omentum, mesentery, and intestines have been removed 
from the body during dissection, the stem of the vena cava passing 
downward lies in full view free of membranes and swollen with blood, 
and shows no offshoot cut from it which could have been presented 
to the organs just mentioned. To make this clearer, I would sever some 
little branch taken to the renal membranes or the seminal vein at its 
origin so that the immediate outflow of blood would prove that I had 
not carelessly cut any offshoot. I would not take sole credit for this 
but would earnestly entreat those present that if they ever discovered 
such veins, they should also not hide them from me, so that some 
day they should repay me, who have learned such different things but 
have been taught by no one, and so I could share the discovery among 
them without envy. 

I have no doubt that Galen believed the liver is divided into lobes; 
it is a fact that he was responsible for its division into five lobes, which 
many under his influence identified with specific names, not as far as I 
know from surviving books of his. However that may be, Galen’s account 
of the liver in man is not lacking in small errors (if only on account of 


its division). In the hollow of the liver, besides the small nerve derived 
from those distributed to the upper mouth of the stomach, I observe 
another 176 neglected by Galen which runs beside the artery presented 
to the liver and originates from the nerve of the sixth pair 1 ' of cerebral 
nerves running along the beginnings of the right ribs. 

But if I were to make an account of the offshoots of small nerves, 
veins, and arteries, I should be overly occupied with an enumeration 
of my observations; what I have written here, which is beginning to 
be tiresome in its great occupations, would be drawn out beyond my 
intentions, as has already happened. I cannot, however, omit the vein 
which a cohort of anatomists starting with Galen contends somehow 
or another extends like a passage from the spleen to the upper ori¬ 
fice of the stomach. By this vein, they argue, melancholic juice that is 
excremental to the spleen’s nutriment is delivered from the spleen to 
the mouth of the stomach, performing, they believe, a great function 
in augmenting the appetitive force of the stomach and restraining its 
strength. They say other things gathered mainly from Galen’s account 
in which he praises Nature’s intelligent design in draining the gall 
bladder not into the stomach but into the duodenum. I should like 
it to be known to those who believe I have missed the vein from the 
spleen that my diligence consists in its investigation, as I have looked 
for this vein not only in animals but also in man in both private 
and public dissections before I published my book De humani corporis 
fabrica, and after its publication at Padua, Bologna, and Pisa. Later, I 
took no small pains to investigate that vessel especially because of a 
certain dabbler 178 who after learning some practical anatomy with 

176 Truncus sympatheticus, believed by Vesalius to be a continuation or branch of 
n. vagus. 

177 Vesalius’ sixth pair of cerebral or cranial nerves includes the modern n. glossopharyn- 
geus (IX), n. vagus (X), and n. accessorius (XI); like Galen, he believed that all three 
nerves were one large “cerebral” nerve, covered by a dural sheath and traversing the 
jugular foramen. 

178 The unnamed dabbler or smatterer ( sciolus ) could be Vesalius’ onetime student 
Realdo Colombo, who succeeded Vesalius in the chair of surgery and anatomy at 


my help (as he is illiterate), and having heard more than once in the 
medical schools that I could not find this passage, or what the mob of 
anatomists imagine is a vein, even though I had placed the stomach 
and spleen clearly before his and others’ eyes, he cut apart some body 
when I was absent from Padua and boasted that he had discovered an 
unknown vein. He believed that after the publication of my book I 
would not return to Italy and would not compare what I had writ¬ 
ten with bodies in public dissections either at Padua or at Pisa (as you 

When therefore I came to the spleen in the order of dissection, 179 
and the bodies of a woman and a man were available at Padua, on the 
day before I had decided to move the stomach I earnestly asked every¬ 
body also to direct their eyes to a careful inspection; I asked them to 
bring along those who had laughed that this vein or passage, as they 
call it, was unknown to me, and I too would learn something from 
them. But as that dabbler, who is otherwise no careless viewer, was 
never absent, he was also mindful not to be present at the dissection 
when these parts or the muscles of the eye were being examined. I 
was therefore compelled to the same conclusions as before when we 
observed exactly the same things as previously. The spleen is con¬ 
nected to the stomach by the omentum, which is attached to the 
lower spleen by a membrane with vessels and constitutes a wrap¬ 
ping for it. Next, an upper membrane is common to the spleen and 
the stomach, delivering veins and arteries which take their beginning 
from vessels going to the spleen and are to be inserted next to the 

Padua. During a brief return to Padua in December 1543 Vesalius heard himself 
criticized by his successor, “so that a generation later Vesalius was still referring to 
Colombo in the bitterest terms.” (O’Malley 1964, 110). See Moes and O’Malley 
1960, 508-28. 

179 Though Vesalius would note in the 1555 Fabrica Vesalius that “different orders of dis¬ 
section are applied to different objectives” (Bk. II ch. 6 ad init.), anatomists regularly 
dissected soft tissues that would decay quickly before proceeding to harder tissues 
such as muscles and bones. Beyond that, the order of dissection was calculated to 
avoid destroying parts that the dissector wished to reserve for later investigation. 


spleen; in humans these make up a large number. None of these pro- 
137 ceeds from the body of the spleen, but as I just said originate from 
the vessels that are to be inserted into the spleen. 

Just as the attachment of the spleen is made to the posterior and 
inferior region of the left side of the stomach, so also not only is an 
abundance of vessels more conspicuous there but also a larger vein 180 
occurs there finally which in humans surrounds the left side of the fun¬ 
dus of the stomach supported by the upper membrane of the omen¬ 
tum. The other veins are much thinner and do not run out very far 
onto the stomach. I have never seen one higher than the rest extending 
in such a way that I could claim the upper orifice of the stomach is 
interwoven with it. We know very well that this orifice takes in veins 
from the offshoot which ascends from the middle of the trunk of the 
portal vein heading to the spleen along the back of the stomach, and 
it supplies the upper mouth of the stomach with many twigs; in dogs 
especially it surrounds the mouth of the stomach in a most elegant way, 
like a crown. Again, the highest of the veins passing to the stomach, 
of those that are closest to the spleen, nowhere resembles in size or 
length the vein that I was saying runs along the fundus of the stom¬ 
ach. Moreover, throughout its progress it has a companion artery, and 
it does not present itself in an array or mode of distribution different 
from the other veins impheating the stomach; it also is not filled with 
a peculiar blood which we could say is either thicker or darker. It also 
does not extend to the cavity of the stomach with its own mouths, as 
do the vessels of the gall bladder going to the duodenum. 181 

But to put it once and for all, it does not differ from all the other 
veins except that it is surpassed by many veins in thinness and brevity 
of passage. My opinion therefore remains the same as before, and it has 
been necessary for those to maintain the same views who were present 

180 Vgastrica sinistra, D in the picture of the stomach reproduced on facing page. 

181 OnVesalius’ demolition of the anatomy on which the humoral theory of melan¬ 
cholia depended, see n. 174 above. 


when I dissected after the publication of my book. For this and other 
reasons I am unable to conceive that the highest vein of those that 
enter the left side of the stomach (not to mention its companion artery) 
separately emit this impure blood and 
melancholic juice into the mouth of the 
stomach for the sake of such important 
functions, although at present we are not 
dealing with the function of the parts. 

In the construction of the kidneys 
I find Galen’s account incomplete. We 
have little more from his description than 
the report that veins and arteries pass 
through the body of the kidney, and that 
urine with a portion of bile which is pre¬ 
sent in the blood is transmitted through 
the dense, hard substance of the kidneys 
while blood is retained, and flows down 
into the urinary passage. 


These imaginary sketches from Fabrica V 
chapter 10 (p. 515) show the conception that 
Vesalius rejects of a “completely trumped-up 
strainer or pervious, sievelike membrane [E] of 
the kidney, allowing urine together with bile to 
pass from the cavity marked B into the cavity 
labeled C. ’’ The ureter carrying urine down to 
the bladder is marked F. 

If one considers what I have said about the construction of the 
kidneys, he will surely not take the flesh of the kidney to be like a 
sieve, as Galen is seen to reckon it, or as most people imagine a mem¬ 
brane in the kidneys, so easily perforated that it lets urine and bile 
through but retains blood as being thicker. However, I shall not repeat 



here the construction of the kidneys as I found it, as it is clear from 
the tenth chapter of the fifth Book of my work De humani corporis fab- 
rica that it is the kind of thing that cannot be grasped in a few words 
(which is all I have available here). 

Galen determined an origin for seminal arteries [aa. testiculares\ 
that was the same as the veins, although we generally observe that 
each artery is brought forth from the front of the stem of the great 
artery lower down than the beginning of the right vein from the vena 
cava, while the left vein gets its beginning from the vein that is pre¬ 
sented to the left kidney. But the intelligence of Nature that appears 
in the course of the right artery was not to be passed over in silence: 
she did not place the seminal artery beneath the vena cava in the same 
way we know the stem of the great artery is laid there beneath its left 
side, but she wished the seminal artery to pass over the vena cava ele¬ 
gantly, in a transverse direction. 

In the construction of the testicles, I wish Galen had explained 
to us what the distribution of the seminal vein and artery is like in 
the body of the testicle. We would have learned, thanks to the pecu¬ 
liar substance of the testicles, that semen is prepared from material 
brought to it in the same way in which it is known the substance of 
the liver makes blood. Likewise, it would not have been unknown to 
us how then semen is taken by the passage that delivers it from the 
body of the testicle and its vessels. 

I shall say nothing about the uterus because I should be too 
lengthy, since I understand that Galen chiefly described the bovine 
uterus and not the human. Several people, however, have written 
me about my account of the uterus, especially my discussion therein 
of the menstrual purgations; mention was made of your letters, my 
Joachim, noting that nothing had been said about the hymen. I said 
nothing purposely, because I knew nothing with certainty: I had 
never dissected a virgin, except one girl perhaps six years old who had 
died of consumption. I had gotten her for preparation of a skeleton 
with the help of a student at Padua who had stolen her from a grave. 


While I was cutting everything away from her bones, at it happens, 
and not taking the time to inspect any part, I did however dissect the 
uterus close to the hymen. Though I found it as I have recently seen it 
after the publication of my book, I did not dare to say anything about 
it because I perceived that animals do not have a hymen. So I never 
take a position on the basis of one dissection or another, and whatever 
harsh remark Terence makes about first coition 182 I had consigned to 
the sort of connection in which we know muscles lying upon each 
other are put together. 

I will pass over the concourse of veins which the Arabs enu¬ 
merate which is called a cento or patchwork by their translators. But 
I should have said more about the opinion that the hymen in small 
girls is not entirely hidden when they spread their legs to urinate. If it 
had been an established fact that this membrane or fleshy septum had 
been called the hymenaeal, I have no doubt that this would have been 
agreeable to the one who named it. 

When I was about to teach anatomy at Pisa there was a shortage 
of bones, and I believed an anatomy should be performed in exactly 
the same order as I had described in my book De humani corporis fabrica 
at the new inauguration of the great university; 18 ’ the anatomy should 
be compared by the students with what I had written. At the com¬ 
mand of the illustrious Duke of Tuscany Cosimo de’ Medici (as he 
was given by the Gods especially for the advancement of studies, and 
he left nothing lacking which could accommodate the students of his 
university), the cadaver of a nun from some hospital had been sent by 
swift boat for the preparation of a skeleton. 

182 Probably a reference to The Eunuch of Terence (161 BCE) in which a 16-year-old 
boy named Chaerea disguises himself as a eunuch to rape the virgin Pamphila, also 
16.The rape is not described except that he tore her clothing and pulled her hair, 
and Pamphila is too traumatized afterward to be able to answer questions about the 

183 The ceremonial re-opening of the Studium at Pisa was enacted on November 



There was also at the time among some of the students a sup¬ 
ply of keys to the rare and elegant cemetery of Sanctus Pisanus so 
that they could search among the monuments constructed in a kind 
of sanctuary if there was anything useful to them for the inspection 
of bones. The best suited are the ones which are placed transversely 
among the monuments of this cemetery and therefore admit rain and 
air. Because some are in monuments beneath the surrounding roof, 
the bones are less useful for study because of decay and the adherence 
of ligaments. In one of these, whose epitaph appeared recently made, a 
hunch-backed girl was laid who had passed her seventeenth year and 
had died, so far as I could guess, from impeded breathing due to the 
bad formation of her bones. 

It could easily be determined that the nun had died from pain 
in the side , 184 an inflammation that occupied almost all the entire left 
side of the membrane enclosing the ribs, but especially at the roots of 
the ribs. 

Similarly, in the same year an elegant prostitute was removed by 
students from a monument next to the church of St. Anthony and 
brought to a public anatomy in Padua; she had died on the third day 
of an inflammation that followed the entry of the unpaired [azygos] 
vein and its offshoots and had occupied the entire back of the thorax, 
providing us an outstanding specimen for recognizing the character 
of the lateral disease. The rest of her body was only slightly emaciated 
and was therefore perfect for dissection, which was the last one I per¬ 
formed at Padua . 185 

So when the cadavers at Pisa were freed of their flesh, the 
nun and the girl whose bones were for preparation of a skeleton, I 

184 Vesalius calls the disease lateralis morbus or dolor lateralis. This “pain-in-the-side” dis¬ 
ease includes pleurisy and related pulmonary disorders; its treatment in Vesalius’ 
time consisted chiefly in venesection. For a discussion of what the dolor lateralis was, 
see Saunders & O’Malley 1947, 8, and Smith 1990. 

185 FabricaV ch. 15 (p. 539) mentions two other female cadavers acquired after this one, 
but not necessarily used in public dissections. One of them, he says, was the model 
for figs. 24 and 27 of the Fabrica. 


inspected the girl’s uterus with a few students who were present at 
the time because I inferred she was a virgin, particularly because no 
one had solicited her favors. I did find a hymen in her, as I did in the 
nun who was perhaps thirty-six years old, no less with the damaged 
testimony of her by now constantly stressed parts. 

Moreover, when we were returning from our expedition to 
France 186 1 was asked by the doctor of Countess Egmondana to attend 
the dissection of a noble girl eighteen years of age whose uncle sus¬ 
pected she was killed by poison; she had been long disfigured by a 
pallid complexion and drew breath with difficulty (though otherwise 
quite elegant in appearance). Because an extremely unskilled barber 
was performing her dissection, I was unable to keep my hands from 
the task. At other times I had never watched another dissector since the 
two inexperienced dissectors whom I first saw at Paris, and three days 
before that at the university in free dissections. So from the narrowness 
of the thorax and of the corset which the girl used in order to be nota¬ 
ble for her slender, slim, long torso, I believe she deteriorated because 
of compression of the breast around the abdomen and lung. 

Since damage to the lung and a marked compression of the vis¬ 
cera in the abdomen had revealed the cause of death and nothing had 
come to my attention by which I could distinguish strangulation of 
the uterus except by swollen ovaries, I dissected the girl’s uterus with 
the doctor for the sake of the hymen when the attendant domestics 
had left with a few spectators to make quick disposal of her foun¬ 
dation garments. However, the hymen was not entirely obvious to 
me, though it was not so hidden as I usually consider it in women 
under sixteen 18 where it is at other times situated, just as if the girl 
had broken her hymen with her fingers or in some other wanton 

186 Following the Treaty of Crepy of 18 September 1544. Comitissa Egmondana is prob- 
ably Anna van Egmont (1533—1588), only daughter of Maximiliaan van Egmond. 
In 1551 she would marry William the Silent. 

187 We have emended vix sedem here to vix sedecim. 


way without using a man, or according to a remedy from Rhazes for 
strangulation of the uterus. 188 

In the neck [vagina] of a girl’s uterus, therefore, soon after the 
beginning of the neck [urethra] of the bladder into the upper part of the 
female fold 18 '' there is a certain transverse septum consisting of a fleshy, 
skin-like substance very like the one of which we see a water-lily is 
formed. This septum is attached at its thickness to the sides of the neck 
of the uterus, a little thicker at its connection than over the rest of its 
surface, though not much thicker than the rest of the membrane. In the 
middle of the septum there is an opening cut like the pudendum in a 
long slit so it will not retain the menstrual purgations in virgins; there is 
no need to imagine any veins below this septum or hymen from which 
menstrual blood would drain in virgins or which should be distinguished 
from the veins that otherwise discharge the menses of women, meaning 
the difference between pregnant and non-pregnant women. 

When Galen described the wrappings of the fetus, he said they 
resemble the wrappings of dogs and pigs; I have easily shown elsewhere 
how well his descriptions describe dogs. I would now do likewise 
if I were as practiced in examining the wrappings of the human 
fetus as I am those of dogs. Since the publication of my book I have 
still had no opportunity to dissect a human fetus still preserved in 
utero.When the opportunity arose once or twice before publication, 
I was so ignorant of these matters, like other doctors in attendance, 

188 Most likely a reference to the ninth book of Rhazes’ Liber ad Almansorem, which 
Vesalius had published in paraphrase in 1537. It covered pathology and therapy of 
small ailments of the body, and had been most recently published in Latin trans¬ 
lation at Basel in 1544. As early as the Hippocratic Peri Parthenion, a variety of 
physical and mental ills was attributed to strangulation of the uterus resulting from 
blockage of the menses in virgin girls. 

189 Here in Vesalius’ Latin the vagina is the cervix, the urethra is a collum, and the “female 
fold” is muliebris sinus, probably the vestibule of the vagina inside the labia. Vesalius 
seems here to have revised his understanding of the urethral opening, which he had 
placed inside the vagina in Fabrica Bk.V fig. 27. But see n. 209 below. The word for 
water-lily is nymphaea. 

and the work had to be so hurried, that there was no opportunity to 
observe the differences between dog and woman. 

There is, in fact, some difference in the fleshy substance that is like 
a fascia in dogs and which for that reason I was sometimes reckoning 
as the outermost wrapping. In women, as I sometimes learned when 
called to women in difficult childbirths, this fleshy mass, which is quite 
similar in substance and makeup to the spleen, nowhere surrounds 
the entire fetus, though it is continuous like the body in dogs but not 
spread about as it is in cows, cervids, and other horned animals. Upon 
these there are nearly uncountable bits of this fleshy substance distrib¬ 
uted through the membrane surrounding the entire fetus in about the 
same way as the dark spots appear on the back of a leopard. 

The illustration on the left 
was added to the 1555 edi¬ 
tion of Fabrica V (fig. 32) to 
show the dark spots (cotyle¬ 
dons or acetabula,marked B) 
on the placenta surrounding a 
calf’s fetus. In the 1543 edi¬ 
tion, Vesalius had illustrated 
the canine annular placenta 
(fig. 30, right) which is no 
more than a horizontal ring (F) around the second wrapping or allantois (G, G), 
which is vestigial in humans. He had still never examined a human fetus in utero. 

However that may be, it is clear enough that Galen’s descriptions 
of the wrappings fall very short of the truth and a complete account. 

Several untrue descriptions gathered from the parts 
contained in the thorax 

In his account of the wrapping of the heart (if I may add something 
about the things that are placed in the thorax), Galen stated wrongly 


that it originated from the base of the heart, though the wrapping 
is no less distant from there than from the point and the remaining 
surface of the heart. There is also an ample interval between the base 
of the heart and the attachment of the heart s wrapping where it is 
joined to the vessels proceeding from its base. The vessels themselves 
do not have this tunic or wrapping in the interval between because 
they acquire it from the adjacent membranes: the vein gets the second 
wrapping and the artery the third. 

But it is still more of a surprise that Galen examined the construc¬ 
tion of the heart so hastily that he wrote that the orifice of the venous 
artery [vena pulmonalis\ is smaller than the orifice of the great artery 
[aorta ], citing reasons why he should reach this conclusion no less effec¬ 
tive than actual dissection, which handsomely shows the opposite. The 
orifice of the venous artery is much larger and wider than that of the great 
artery, as Nature did not build it contrary to reason and uniquely good 
design. But Galen not only argued that the orifice of the great artery 
is larger than that of the venous artery, he also decided that it is much 
greater than all the orifices leading into the heart, comparing it also to 
the orifice of the vena cava, though in fact without any falsehood it is 
seen that the orifice of the vena cava is even twice as large as the orifice 
of the great artery. 

It is impossible for someone to place no importance on these 
descriptions by Galen that are utterly inconsistent with the truth. 
Or even when one has learned of his carelessness in dissections, he 
may blame his editions of Galen. For as a result of his false state¬ 
ments about these orifices one may gather as many arguments 
against Aristotle and sometimes Erasistratus, and again in praise 
of Nature. Though these are powerful statements, it is finally well 
known to a person who carefully inspects the fabric of the heart 
that he admits the greater propositions of Galen; then he accepts in 
a lesser way outside the truth of the matter something other than 
he believes, afterwards determining a true conclusion at odds with 

1 12 

Galen’s opinion. Since such opinions have come to my attention 
in Galen which contradict the opinions of the Ancients, and as I 
am compelled to admit that Aristotle is much more deserving than 
Galen in studies that are common to both — though I swear by the 
words of Galen 1 " : — should it seem strange to someone if something 
irreverent escaped from me against Galen? Careful as I have been 
at all times to prevent this from happening, as long as I live I shall 
try to avoid having anyone say that about me truthfully I am ever 
so annoyed by those who are in a hurry to purge Galen of false rea¬ 
soning.You know with how inconstant a mind, and one not entirely 
dedicated to Galen, those frivolous objections which are sometimes 
not without malice are able to provide the occasion for someone to 
become zealous to accumulate errors in Galen, collect them into a 
single volume, and publish them. I shall never attempt this, since I 
respect Galen more than any mortal. Although I show what he did 
not think about, this is only so that when I explain true anatomy no 
one will think because of his authority that I am pointing falsehoods 
out to people. 

This happens in the description of fibers that are brought out 
of the membranes controlling the orifice of the vena cava which I 
believe are attached along the sides of the right ventricle of the heart 
to the substance everywhere at its point; Galen on the other hand said 
(though falsely) that they are attached only to the ventricular septum 
of the heart. 

Similarly, in the small glands of the throat someone would 
believe that I was imagining a third type of glands if I had not added 
to my account that Galen had missed the small glands resting at the 

190 An ironic tag from Horaces nullius addictus iurare in verba magistri ( Episl. 1.1.14, 
“given to swearing by the words of no master”), from which would later come the 
motto of the Royal Society of London, Nullius in verba.Ve salius had begun using 
this tag (without irony, labeling himself a habitual skeptic) in FabricaV ch. 13, and 
he repeated it three more times in Books V and VI. 

root of the larynx where its second [cricoid] cartilage was attached 
to the remaining stem of the trachea; these glands have a large num¬ 
ber of their own glandules, noteworthy and unlike any other type of 

False descriptions among the parts that are surrounded by the skull 

Likewise when I survey the process of the hard membrane that comes 
between the right and left parts of the cerebrum and also the one that 
separates the cerebrum and cerebellum, I deny that they are doubled 
(because in fact they are single and correspond in substance to the 
sides of the hard membrane). I might perhaps be blamed, because 
Galen imagines the hard membrane is doubled at that point, being 
confused by the sinuses that stand in the area of those processes 
where they are joined to the skull. Again, when I pursue the study of 

the cerebrum and say that it 
is continuous I have to warn 

One of several cross sections of 
the cerebrum in the Fabrica (Bk. 
7 fig. 5, p. 609) showing parts 
that are common to the left and 
right sides. The corpus callosum 
(R, R, R) has been cut away 
from the front of the brain and 
folded back, exposing the upper 
suface of the fornix (S,T,V). 
The colliculi are still out of sight 
beneath the septum pellucidum 
(X, X) that separates the two 
ventricles (L L, M M). 

1 74 

the reader that it is not so divided into a right side and a left that it 
is nowhere continuous. 

That is because Galen’s account, where he explains the reason 
for the brain’s division, sounds no different than if the cerebrum were 
doubled like the two eyes and two ears that we know Nature gave us, 
though in fact the cerebrum is continuous at its base not only because 
of the body that we call the corpus callosum but also because of the 
one [ fornix] that we compare to a tortoise shell or vault, the one we 
compare to buttocks [colliculi inferiores] and testicles [colliculi superiores ], 
and finally the large portion of the cerebrum itself from which the 
beginning of the dorsal medulla issues. 

In describing the beginning of the dorsal medulla, I could not 
fail to remark that Galen described it as if it did not hang down from 
the cerebrum and as if its entire substance were not continuous with 
the cerebrum. When Galen inquired into the reason for the construc¬ 
tion of the cerebellum and determined that it was simple and single 
for the sake of the dorsal medulla (which needed to be single and not 
double like the cerebrum in its upper area), he set about his account 
just as if the cerebellum were not continuous with the cerebrum and 
also put forth a single dorsal medulla. It may be seen in my writings 
how foreign these ideas are to the true fabric of the body; one will 
immediately understand that they are false, as I just said, because Galen 
taught differently from me — though when admonished (if he were 
studious of the truth) he would moderate his opinion so long as he 
learned from dissection and examination of the body how the matter 

The situation is the same when I say the anterior part of 
the right and left ventricles is blunt and large; they are not con¬ 
fined to a narrow space there, and they end at the olfactory organs, 
which like canals deliver phlegm to the [ethmoid] bone of the head 
that is permeable like a sieve. Much of this, which Galen reported, 
is quite foreign to the true fabric of the cerebrum. Among the 

errors, the least to be neglected is that when Galen pointed out 
that the ancient professors of dissection, when describing the pro¬ 
cesses of the thin cerebral membrane, stated that portions of this 
membrane were borne into three cerebral ventricles, he quickly 
imagined that these ventricles were lined and coated with the thin 
membrane, and deduced that the reason for this was the softness of 
the cerebrum, as if the ventricles would have collapsed unless they 
were supported by the thin membrane. This is the difference by 
which Galen distinguished the fourth ventricle (which we locate 
in the cerebellum) from the three preceding: that is, because it is 
harder than would require it to be lined and supported by a thin 
membrane. However, the previous ventricles are no less invested 
by a thin membrane than this fourth, and the fourth ventricle was 
said by the Ancients to differ elegantly from the previous ones 
because no process of the hard membrane presented itself therein. 
Therefore networks like a placenta are visible in the previous ven¬ 
tricles as well as vessels entering into the constitution of those 

Finally, I would like to avoid spending any more time on false 
descriptions, but I have not been able to pass over the errors of Galen 
which occur in great numbers in his description of a reticular plex¬ 
us. 191 Of all the parts in the body there is none as talked-about by 
doctors and philosophers as this blessed and wondrous network. In 
its description I was unable to accept that the carotid artery where 
it is closest to the skull is brought whole into the head since it sends 
48 such a noteworthy portion backward which is drained into the 
sinus of the hard membrane [sinus transversus dexter\ that I call the 
first. I will not now discuss the fact that Galen was altogether igno¬ 
rant of the foramen [canalis caroticus ] by which the greater part of the 
carotid artery is borne elsewhere inside the skull cavity. However it 
was that Galen traced its path in his account into the space of the 


See n. 141 above. 

head or the skull, he attests that all of it is taken up into some net¬ 
work which he compares to nets lying upon each other, without 
noticing the large offshoot presented to the sides of the hard mem¬ 
brane or the noteworthy portion extended to the nasal cavity; he 
also does not notice the large twig which goes with the second pair 
of cerebral nerves to the eye socket and the eyes themselves. So it is 
that it should not come as a surprise if I do not agree everywhere 
with Galen’s description, and many things appear in his books from 
which I cannot quote examples of true descriptions as I would like 
to clear myself of Sylvius’ false charge and provide his disciples with 
material fit for sharpening their pens — if only they were willing to 
be occupied otherwise than in exalting Galen in their praises (which 
I do not think is my task), snarling in unison without recalling all 
the places where they think I have censured him, and chattering 
calumnies and insults. They should together consider whether they 
have taught others what they are saying, or have dissected with their 
own hands in public universities in the presence of the most learned 
men, not ones who are still untrained in medicine and students who 
are just beginning. 

Some places where it is known that Galen was not altogether 
sound in assigning the functions and uses of 
the parts 

At present it is claimed that I have falsely put it out that Galen made 
even the smallest mistakes in accounting for the function or use of the 
parts. I can refute this charge, so may the Gods love me, with a much 
larger number of reasons than was available for the two ideas of Galen 
previously mentioned. If time now permitted, as it did when I was 
living in Academia, and I was dedicated to our studies and not to the 
labors of my craft, and I had the choice of sitting idle at home, I would 
scrutinize at much greater length than I did in other places that have 


Z 77 

been criticized the uses and functions wrongly assigned by Galen and 
actions that have been incorrectly explained. However that may be, 
from a great heap and storeroom, so to speak, I am willing to add at 
least a few places so you may have an example from this portion of my 
reply to the letter of Sylvius. 

In his account of the bones 

I will pass over several foramina of the skull in assigning whose use 
Galen’s mind was wandering no less than in his descriptions, as in 
the foramen 192 transmitting the second pair of cerebral nerves; in the 
foramina carved in the cribriform bone [os ethmoidale, lamina et foram¬ 
ina cribrosa], which we have written is located in the base of the frontal 
bone; in the foramen [f. ovale] transmitting the third and fourth pairs 
of cerebral nerves; in the foramina [canales carotid] made for offshoots 
of the carotid artery, which came at the end of what I was saying 
above; and in the use of the bone [os sphenoidale] resembling a wedge 
at its base, where he said wrongly it is pervious like a sponge 19 ’ and 
thereafter imagined both actions and functions there without any 
logic (as has been shown elsewhere). I should explain motions of the 
head, unless you think something should be brought in first by way of 
general descriptions of the bones. An example is where Galen is sum¬ 
marizing the use of epiphyses and writes that they are given to bones 
to be covers for the cavities in which the marrow is held. He did not 
consider that in bones that have such a cavity Nature did not place 
an epiphysis over those cavities where the reason for their composi¬ 
tion and the series of various processes and protuberances required 

192 Fissura orbitalis superior. In Fabrica I ch. 12 (p. 50) Vesalius had written that it is larger 
than the foramen for the optic nerve, disagreeing with what Galen had written in 
Book 9 of De usu partium (3.718.14). 

193 “Galen wrongly left it written that this bone is perforated like a sieve or sponge and 
transmits cerebral phlegm.” Fabrica I ch. 6 (p. 32), citing Galen De usu partium Book 
9; see 3.694.Ilf: “The gland is succeeded by a bone like a colander, that terminates 
at the palate, and this is the route of the thick residues.” 

particular hardness, as happens in the lower part of the humerus and 
the upper region of the ulna. 

Also, an epiphysis does not develop on bones in which those 
cavities are large and hollow without an interval of bones, unless 
the bone itself has already become softer than it is along its entire 
length, is beginning to have a substance identical to the epiphysis, and 
the cavity is hardened prior to the common material of the epiphyses. 
Moreover the scapula, which nowhere shows such a cavity, has a great 
abundance of epiphyses, just as do the bones attached to the sides of 
the sacrum; these bear an epiphysis covering the entire spine of the 
ilium. A large epiphysis is also given to the hip bone where it provides 
a beginning to so many muscles moving the tibia and the femur. 

Again, how many epiphyses abound on the vertebrae? They 
do not, though, have a cavity in which marrow is placed by itself. I 
know that marrow, or at least a juice which we have to compare to 
marrow, is contained in all bones having a spongy substance, and in 
their epiphyses. In assigning this use of the epiphyses, Galen should 
have considered how in small children the epiphyses are mostly 
cartilaginous, and then how their substance differs in softness from 
the other part of the bone, so that he would not invent the idea 
that Nature constructed epiphyses or covers of cavities containing 

So far as concerns motion of the head over the first vertebra, and 
of the first vertebra with the head over the second vertebra, and then 
of the head with the entire neck, I cannot sufficiently wonder why I 
should be condemned by anyone for not agreeing with Galen and for 
putting forward something completely at odds with what he wrote: 194 
nobody’s mind should be so imprisoned that he should not set aside 
some fondness and descend to my view, unless he is put off my ideas 
because they were proposed by a young man and he himself had 


On this subject see Fabrica I ch. 15, “Galen’s opinion about the motions of the 
head” (pp. 63—5), where Vesalius mounts an extended critique of Galen’s view. 


read and corrected the books of Galen so many times and translated 
them into another language that he was ashamed not to have previ¬ 
ously observed these facts himself, particularly in the motion of the 
head, in whose description Galen requires a more learned and atten¬ 
tive listener than in any other matter, however serious and elegant. In 
addition, it must be admitted that so many uses of muscles and liga¬ 
ments were badly explained by Galen, since he erred in describing the 
motions of the head. 

I do not know whether Sylvius was influenced by the fact that 
while making this argument in my book I wrote that I had been 
left without the aid of a preceptor 195 — though perhaps he believes 
I learned anatomy from him, who still contends that Galen wrote 
nothing wrong. As long as I live I should note that Sylvius began in 
his fashion to read us Galen’s work On the Use of the Parts. But when 
he came to the middle of the first book, and the anatomy, he declared 
that to be more difficult than we could follow as medical students, 
and therefore, he said, it would equally torment both himself and us. 
Then he began the fourth book as far as a portion of the tenth. After 
that, again leaving out the material in between as far as the fourteenth 
book, he also read the later books in such a way as to cover a book a 
day or in five or six days, never warning us that Galen had said some¬ 
thing different elsewhere (as often happens), or showing that some¬ 
thing written by Galen was contrary to how the matter stood, at the 
same time bringing into class parts of nothing except a dog. In dissect¬ 
ing these parts we students were so painstaking and imitated the best 
teacher, that he never once tested our diligence after his lectures. So 
it then happened that on another day we showed him the membranes 
controlling the orifice of the arterial vein [truncus puhnonalis ] and the 
great artery [aorta] which on the previous day he had assured us he 
was unable to find. 

195 See Fabrica p. 63: “It should seem strange to no one that I too was very much in 
need of a preceptor’s aid in this part.” 


Since Sylvius had skipped the places dealing with the verte¬ 
brae along with many others in his so-called course of 1535, and had 
never read us another anatomy 
book (except De tnotu musculo¬ 
rum, in which he also thought 
Galen’s opinion was consistently 

The first three cervical vertebrae seen 
from behind in fig. 11 ofFabrica Ich. 

15 (p. 60). N is the articular surface 
of the atlas or first vertebra, joining 
the neck to the occipital condyle of the 
head. T identifies the dens or tooth of 
the axis or second vertebra, creating 
the swivel on which the head rotates. 


correct), it is no surprise if I write that I lacked the service of a pre¬ 
ceptor and was especially watchful to be counted among those lis¬ 
teners whom Galen did not repel from his books when explaining 
motions of the head and who believes those movements are suitable 
for understanding the mysteries of Nature. 

So it came about that I 
said the head is flexed in its own 

This figure from p. 66 of the Fabrica 
illustrates the ligaments that restrain 
the dens of the axis within the hollow 
of the atlas or first cervical vertebra (A, 

B, C). The dens (H) is seen within 
the cruciform ligament, whose supe¬ 
rior band is marked I. Tire transverse 
ligamen t of the atlas is marked K. 

motion above the first vertebra and is moved upward or to the rear, 
while Galen teaches that the head is moved to the side above the first 



vertebra as if we were inclining it to the shoulders. He introduces 
nothing else explaining motions of the head, particularly in the place 
where he states that the condyle of the occipital bone is elevated 
from its depression in the place that stands directly opposite the side 
toward which the head is moved. Not only is Galen content to have 
described the motions badly, he also attributed such negligence to 
Nature that in the worthiest joint of the entire body she wished for 
the bones to draw apart and separate from each other in the motion — 
though in fact for the best of reasons we never see an empty space 
made between the joints in any motion. 196 It is therefore clear enough 
that the motion to the sides is attributed by Galen to the joint of the 
first vertebra with the second, though in fact the head is not moved to 
the side by its own motion but only indirectly with the entire neck, 
which is moved gradually in an arc to the side with all the vertebrae 
consenting to this motion. 

Still less skillfully, Galen taught that the head is flexed forward 
and back with the first vertebra over the second, in the motion that I 
said is performed in the first. 

Clear language in three different books attests what Galen’s 
opinion was about that; a still worse mention of the use of a liga¬ 
ment states what prevents the dens of the second vertebra from crush¬ 
ing the dorsal medulla in anterior flexion of the head. The fact is 
that the ligament restrains the dens so it is sequestered in the hollow 
of the first vertebra in the way that an axle is known to be rotated 
upon by a sphere or wheel or some such thing. The head (whatever 
Galen teaches, or the disciples of Sylvius sharpen their pens and write 
while paying no attention to the nature of the dens) is rotated over 
the second vertebra and is in no way flexed or extended over it; Galen 
in the meantime mentions no joint on which the head is rotated. 

196 These criticisms of Galen are made at greater length in Fabrica I ch. 15 in the 
sections titled “Galen’s opinion about the motions of the head” and “A different 
opinion from Galen’s about the motions of the head.” A later section in the same 
chapter, titled “The worthiest joint in the whole body,” about the joint between 

Z 82 

If anybody were to argue that Galen understood it as a motion of 
shaking the head and assert that this was his opinion, that the head 
is rotated over the first vertebra, such a person will soon see what an 
absurd suggestion this is even for the sake of a joint: for the two con¬ 
dyles of the occiput go into two deep sockets laterally opposed to each 
other so that the head can not be rotated over the first vertebra, any 
more than a compass whose two legs are fixed in a stake. It is as clear 
to me that I am saying here what fits the truth and that the structure 
of the bones is consistent with my views, as I strongly believe that as 
soon as this attack of Sylvius cools down he will doubtless agree with 
me — if only he would carefully display the bones to his disciples and 
inform them of contrary views so he could observe with them how 
Galen’s badly described motions of the head confuse many things in 
his account. None of these prevents us from confirming that Galen 
was not altogether perfect in assigning the use of the parts. 

My writing would be unnecessarily prolonged if I were to 
revisit everything here about the muscles - and ligaments that nec¬ 
essarily follow a misunderstood motion. I would deserve thanks 
even for this observation were not Sylvius so agitated against me 
in his letter. When Galen mentions the process [tuberculum anterius\ 
seen in the front of the first vertebra, shaped for the strength of that 
vertebra and the insertion of muscles, as we rightly stated, he should 
not have forgotten his doctrines there and assigned it the function 
of pushing the head upward when it is inclined forward. 197 The 
head cannot ever be inclined so far that it rests on that process in 
such a way that it would perform that function. Anyone by whom 
the way bones are put together is understood has no doubt that 

the first vertebra and the occipital condyles, specifically faults a passage in the 12th 
book of Galen De usu partium (4.1 ff). 

197 Galen De anatomicis administrationibus : “The anterior arch of the first vertebra pre¬ 
vents the head from slipping too far forward, fixing and raising the head just before 
it goes too far.” chapter 8 of the fourth book, §461, tr. Singer 1956, 113.Vesalius 
rejected this view in Fabrica I ch. 15 (p. 64). 




this is quite clumsy and in any case has nowhere been attempted 
by Nature. 

Galen, who occupies himself so much in explaining why the 
two lower thoracic vertebrae lack transverse processes, should have 
noticed that his opinion is false unless he had explained by the same 
token that the two vertebrae resting upon the tenth also lack the 
same processes. But as those vertebrae have the processes, so too 
Galen’s arguments in this place are, as I explained above, untrue. As in 
anatomy Galen often made contrary statements, so it should not be 
surprising if sometimes he teaches that the same part was fashioned 
for contrary functions. An example is found in the acute process of 
the ulna [processus styloideus ], in whose description Galen has been 
shown to have strayed far from the human fabric. That process is not 
extended beyond the remaining series of rims of the depression to 
which the carpus is articulated and is not coated with smooth, slip¬ 
pery cartilage, nor does it enter the socket of the third carpal bone as 
it would in a joint. 198 

As Galen fell far short of the truth in describing this joint, so too 
in his book De ossibus he wrongly wrote that the hand is moved 
obliquely by the joint of that acute process with the wrist, meaning I 
suppose the motion by which we move the hand to the side. If that 
styloid process went higher and were articulated as it presents itself 
in sheep, or as Galen writes, it would act like a stake and prevent 
the hand from moving to the outside; so far is that from the motion 
that Nature made it control. In his book De usu partium he not only 
attributed that lateral motion to this acute process but he also made 
it responsible for pronation and supination. Because that agrees with 
the truth, it must be distinguished from the motion of a hand which 
in no sense is moved to a prone or supine position by its own peculiar 

198 This paragraph recalls a theme previously mentioned: see p. 104 above. Vesalius 
makes this argument more fully on p. 114 of the Fabrica (Bk. I ch. 24) where he 
details the cartilage separating the wrist from the forearm. 


motion. So poorly did Galen follow the skill of Nature by which the 
wrist joint as much as possible related only to the radius, by means 
of which the hand fitly undergoes derivative motion together with 
the radius; the sharp styloid process would prevent such motion if it 
matched Galen’s descriptions. Similarly, we see that sheep and calves 
lack this motion of the joint because of the partnership, so to speak, of 
the ulna with the radius. So I should deservedly be judged mad if I so 
openly defied my reason as to say with Sylvius that Galen was wrong 
in his description of no part, function, or operation. 

Because Galen taught no difference in the joints of the fingers, 
it is also no surprise that he did not think about Nature’s craft in the 
lateral motion of the fingers. Because it is now very certain that the 
longest foot did not fall to man’s lot but rather the shortest, no one 
should be in doubt how many faults can be found in the third book 
of De usu partiwn if he wants to spend time on matters that are all too 
clear and at the same time frivolous. 

Several uses and functions not well assigned in Galen’s 
account of the muscles and ligaments 

Earlier, when we pointed out the unnecessary blending of hgament 
and tendon that Galen imagines in the muscle (reasoning sometimes 
from elsewhere, sometimes from muscles that nowhere have their 
fibers more separated and scattered from each other than in their ori¬ 
gin and from muscles that are seen to be as large in their origin and 
mid course as in their insertion), it was also easy to notice that flesh 
is not given by Nature to the muscles chiefly to be a fulcrum and 
layer of some division created to contain the fibers; but if we duly 
consider the construction of a muscle we think of flesh as its principal 
substance just as we think of a particular substance not common to 
any other part in the lung, the liver, the spleen, the kidneys, testicles, 
brain, heart, and in all organs in charge of a peculiar function. The 
material of ligaments is given to a muscle for strength, so there would 

IS 6 

Z 85 

be something which when contracted by the gathering of flesh would 
pull upon that into which the muscle was to be inserted. The muscle 
has need for a nerve chiefly for animal force, 199 which it provides just 
as we notice venous blood and arterial material is delivered, if we are 
dedicated to a zeal for truth and do not set too much store by authors. 
Just as we see a set of nerves paired with veins and arteries, we also 
see that it is suitable for a muscle that animal force be imparted most 
of all to the place where the muscle needs to be gathered into itself 
and where it will act upon the part to be moved. I believe I have 
argued about these matters elsewhere, so I will not need to hnger on 
them now. 

Vesalius’ illustration of the eyelid 
muscles at the beginning of Fabrica 
II ch. 10. His first muscle (lig.palpe- 
brale mediale) is labeled A, C, b; the 
second (m. orbicularis oculi) is marked 
D, e. The two meet at F. Vesalius 
added a short chapter to the 1555 
edition (ch. 10) on the dissection of 
these muscles. 


As Galen is inconsistent in counting the muscles of the eyelids, 
he also disagrees with himself about their function. In his book De 
usu partium he counts two muscles, one at each angle of the eye, of 
which he says the one that occupies the inner angle of the eye moves 
the eyelid upward; the one in the lesser or outer angle, he believes, 
causes downward movement of the eyelid. In his book De locis ajfectis 
he writes that those two muscles move the eyelid downward, and 

199 On this vaporous animalis vis, see n. 156 above. The existence of separate animal 
spirits was to be challenged in 1556 by VesaHus’ contemporary and fellow neoteric 
Giovanni Argenterio (1513—1572), De somno et vigilia Book 2 chaps. 7—10. See 
Siraisi 1987, 339 and 1990, 177. 

Z 86 

Vesalius’ illustration of the 
eye muscles from Fabrica II 
ch. 11 (p. 239). Tire muscle 
labeled O, the retractor bulbi, 
is a bovine muscle not present 
in humans. The other muscles 
(H, I, K, L, M, N) have been 
pulled away from their usual 
position covering the retractor 
bulbi. B identifies the optic 

imagines a third muscle that 
would be responsible for 
elevation of the eyelid. 21,11 
My judgment about them is clear where I placed my account of the 
muscles of the eyelid. 

When after six previous muscles Galen described the muscle of 
the eye which he sometimes perceived as several muscles and some¬ 
times as a single one [m. retractor bulbi], he does not seem to me to show 
very well the function of the one by which the eye is kept in its place. 
In animals as also in humans, that muscle is inserted in the back of the 
eye more or less at its base, at the entry of the optic nerve. It ends in 
a circle as if at a point near its beginning, drawn over the optic nerve 
and is thus covered and coated by the six previous eye muscles and 
the fat lying beneath them, so that it nowhere touches the bone of the 
skull. I hear that some people are putting it about that I am describing 
bovine eyes rather than human 2 " 1 because they have seen that I always 

200 A passage in De locis affectis, 8.220.14ff., notes that both the eyelid muscles and their 
innervation are hard to see in large animals, but that there is one muscle that opens 
the eye and two that close it (8.221.4—7). 

201 In De re anatomica (1559, p. 216), Realdo Colombo wrote that like Galen before 
him Vesalius dissected an animal instead of a human eye. 



bring bovine eyes to dissections and because the eyes illustrated in my 
book appear much larger than the eyes of a human. I have certainly 
always displayed bovine eyes in classes because human eyes outside 
the order of dissection 2 "- were too flabby and small. I would, however, 
also dissect human eyes whenever they were available. I did so more 
than once in private dissections when I judged it was permitted to 
look at [human] eyes soon afterward, but I saw no difference in the 
muscles. However, the pupil is much smaller in the human, nor are the 
green, blue, and very black colors to be seen on the inside of the uveal 
tunic [tunica vasculosa bulbi, choroidea ].Therefore I am still compelled to 
admit that Galen needs to be corrected in describing the use of the 
muscle that he enumerates so casually. 

On account of the distinction of colors in the uveal tunic, I say 
that bovine eyes, like the brain of cattle and not humans, were what 
he dissected: the green, blue, and very black colors occurring in the 
inner region of this tunic but not the one that stands on the outside of 
the uveal tunic where this faces the cornea and the transparent tunic 
of the eye. Because of this color, we say humans have white, black, or 
grey eyes. That is the color in the uvea itself, whether the eye is seen 
still full of humors, or after they have been drained. 

I would like careful students to pay special attention at the point 
where Galen writes about the temperaments of the eyes resulting 
from this distinction of colors. It is unlikely that those who consider 
Galen’s fanciful thinking will fail to wonder at this Paradox of mine 203 

202 On which see n. 179 above. 

203 The 1555 Fabrica (Bk.VII, ch. 14) explains the paradox as follows: “This color is 
never the result of an abundance of humors in the eye, a lack or thinness of humors, 
the accumulation or enlargement of the pupil, or the depth or shallowness of the 
eye, nor should it be thought the result of some similar cause. Though it may seem 
a great paradox to those who have filled entire books about eye color, I can approve 
no view except that the color of each persons eyes (however varied it may be, and 
inconsistent in either eye and sometimes even in the same eye) is always the same 
in the uvea, whether you examine it when the eye is intact, in what runs out of a 
severed eye, in the humors as a whole, or when the uveal tunic has been detached 
and removed from those adjacent by dissection. I therefore believe one may argue 


(if they are held by love of the truth), unless we are willing to invent 
something about color, which is clearer or less clear in the pupil itself 
depending on its size. But it is easier to talk nonsense about this than 
to make true statements, so we may set aside the authors. 

Returning to the muscles, from which my theme had digressed, 
I shall say nothing about the temporal muscle and the masseter; in 
describing these and telling their use, Galen was quite false in De usu 
partium, though in De anatomicis administrationibus he corrected himself 
and gave a fine description of these muscles without mentioning De 
usu partium — as if he hoped he would review that work some time. 
As it has happened in certain other places, the muscles that flex the 
first finger joints, the muscle [m.popliteus] hidden behind the knee, the 
muscle in the axilla of apes and dogs that is made of a fleshy mem¬ 
brane, and some others that are mentioned out of the usual order in 
De usu partium and sometimes interrupt the argument he is making 
as if he had only jotted them down in the margin, show and prove 
how casually the description of the muscle located behind the knee 
comes in. However, based upon what Galen himself says, it is clear 
elsewhere that these muscles were unknown to him when he wrote 
De usu partium and the earlier books of De anatomicis administrationibus 
which had perished in a fire. 204 

But these matters have to do with another place. I began this 
account so that you would not think me so negligent that I would not 
have observed statements made by Galen that are bad anatomy and 
scattered in his book about the use of the parts, concerning the mus¬ 
cles that move the lower jaw. Nevertheless, because I have come upon 
the mention of contrary and conflicting passages in Galen concerning 

about eye color in the same way that one may argue about a black, swarthy, or 
white skin given to people in utero, or about red, blond, or black hair, as we see 
about the same kind of skin and eye color is observed in various nations.” 

204 “In 192, a great fire burned down the Temple of Peace and many other buildings 
in the neighbourhood. The temple was a meeting place for intellectuals, and also 
served as a book repository and store. Galen lost all his copies of his own books in 
it, some of them irretrievably.” Hankinson 2008, 21. 

a description of muscular function, I cannot omit the muscle [in. 
omohyoideus] that I describe as implanted from the scapula into the 
hyoid bone and declare to be a private muscle belonging to that bone, 
as Galen also in De usu partium, when listing the muscles of that bone, 
particularly describes. However, in the same book, just as he does in 
De anatomicis administrationibus, he introduces this muscle as a mover 
of the scapula; this muscle therefore shows no trivial inconsistency in 
Galen: especially as it is a slender muscle, it cannot be counted in the 
number of those moving the scapula. 205 

What is the point of discussing muscles moving the head, that 
are conspicuous in so great a number? I am altogether certain that 
Galen was deluded in describing motions of the head. The muscle [m. 
teres major] originating from the lower rib of the scapula and ending in 
a long insertion below the head of the humerus where the first muscle 
of those moving the arm [m. pectoralis major] is implanted and takes 
for itself the front of the breast, draws the arm backward in a motion 
which I identify as the first. It is by no means (although Galen said 
so) the author of rotation of the arm to the outside. From this it is 
immediately clear to what extent Galen perceived Nature’s artifice in 
the muscle [m. infraspinatus] occupying the convex side of the scapula 
and attached by a large insertion to the head of the humerus and the 
ligaments of the joint here, and causing rotation. 

The muscle [m. latissimus dorsi] drawing the arm downward, 
originating out of the back from the spine of the sixth thoracic verte¬ 
bra all the way to the lower part of the sacrum, is not inserted in the 
scapula; Galen wrongly gave it the function of moving the scapula. 
The muscle in simians and dogs that is made of a fleshy membrane 
and is not present in humans readily shows by the actual course of its 
fibers, which Galen describes accurately, that it does not perform the 
function Galen ascribes to it in a simple and direct downward motion. 

205 See p. 58 above for Vesalius’ first mention of this topic. In De usu partium Galen 
described the omohyoid muscle as moving the shoulders forward or toward the 
neck: 3.592.18-593.1 (May, 1968, 374) and 4.140.5 (May, 1968, 618). 

Likewise, Galen badly described the origin of the muscle [m. pectoralis 
minor\ which I number the first of those moving the scapula; 206 it lies 
beneath the muscle drawing the arm to the chest and is inserted in the 
inner process of the scapula, not in the humerus nor in the ligament 
of the joint, particularly in humans. He also made a major error in 
describing its function when it was not enough for him to have writ¬ 
ten that the arm is adducted to the chest with the aid of this muscle 
but he went on to say that it performs its highest adduction toward 
the clavicle. In the first place, it does not move the arm; and since it 
makes its beginning much lower, from the second rib or a little lower 
than the first of the muscles moving the arm, which it brought from 
the clavicle and the sternum, it is quite ridiculous to think that this 
muscle of the scapula, even if it were inserted in the humerus, can 
adduct the arm higher to the chest than the higher part of the first 161 
muscle moving the arm [m. pectoralis major]. I will not say how much 
lower it is inserted in the humerus and descends lower from its higher 
parts than the insertion would be of a muscle moving the scapula, 
wrongly ascribed to it by Galen. 

In the muscles moving the thorax, I shall bypass the diaphragm 
itself along with other muscles and consider only the intercostal 
muscles because their use, unknown by Galen, makes me aware that 
he wrote many things that he had never seen or dissected but had con¬ 
ceived only in his imagination out of false principles. Everyone who 
has not surrendered to the authorities but believes in the truth will 
agree with me and consider it evident that Galen did not know the 
function of the intercostals. As he himself is more than once inconsis¬ 
tent and often varies both in his descriptions of things and in assigning 
uses and functions, so too we find his opinion about the function of 
the intercostal muscles is unsettled. He everywhere teaches that these 
muscles relax and compress or tighten the thorax, or are in charge of 

206 This argument was made in Fabrica II ch. 23 in the section headed “The mus¬ 
cle that moves the scapula forward is mistaken by Galen for a mover of the arm” 

(pp. 263f.). 


inspiration and expiration. But in one place he writes that the inner 
intercostals open the thorax and separate the ribs while the outer 
intercostals compress and tighten it, while in another, by contrast, he 
declares that the thorax is opened and the ribs separated from each 
other by the outer intercostals and the ribs are gathered together and 
the thorax tightened by the inner. Since this conflicting opinion pres¬ 
ents itself, it is easy to believe it is one and the same, taking refuge in 
errors of the texts, since it is easy to write “exterior” for “interior.” But 
however we now imagine Galen’s opinion to be consistent, it must 
always be admitted that Galen made either the inner or the outer 
162 intercostal muscles the authors of opening of the thorax and of 
separation of the ribs from each other; but I should have thought both 
the outer and the inner muscles control the drawing together of the 
ribs and the tightening and narrowing of the thorax. 

I have never been able to invent an explanation of how soft 
bodies in the spaces between hard ones should be able to be drawn 
together (which is the chief property of muscles) in such a way as 
to force the hard bodies to draw apart from each other or separate, 
and not come together. Nor has anyone so far tried to contrive me a 
way — in the presence or absence of a cadaver — in which Galen could 
have proven his opinion, especially after he had closely inspected the 
nature of intercostal muscles. So many reasons present themselves why 
they all act to tighten the thorax. I have considered them in dead 
and living bodies with all possible diligence, earnestly asking those in 
attendance that if they disagreed with my opinion to give a reason for 
their opinion (other than the authority of Galen) why it should [not] 
yield to mine. 

It is an embarrassment to the name of Galen, whom we con¬ 
sider our common preceptor and our guide everywhere through the 
entire art of medicine, that he erred in assigning the task of these 
muscles, and labors under such suspicion among us because hereafter 
we will not dare trust him without the best reasons. He tells of many 
vivisections that hinge on the function of the intercostals, so it is all 

too clearly known that he conceived of them with little intelligence 
if he did not know their function. But there are several such instances 
which seem unskillful in other ways and testify that they were more 
imagined than tested by experience. 

What shall I say about the use of muscles moving the back as 
mentioned by Galen? He paid no attention to four major muscles 
moving the back and passed them over as if they did not exist. I 
think nobody is so stupid that because of ignorance of those muscles 
he does not believe the function of other muscles as well is wrongly 
described.Yet in numbering them and describing their function Galen 
was so succinct that very few errors can be counted therefrom in his 
account of their uses. However, in De usu partimn he wrote falsely that 
the muscle flexing the third joints of the four fingers is also inserted 
by its tendons into the first bones; he added that those bones as well 
are flexed by this muscle. But when he wrote De anatomicis administra- 
tionibus and considered on the basis of a more careful dissection that 
this insertion is not in the nature of things , 207 he attributed the same 
function to the muscle just named. But he attributed flexion to the 
transverse ligaments by which the tendons are contained above the first 
bones. Since, therefore, Galen corrected himself, we must accept the 
opinion here that is closer to the truth, as we always do elsewhere. 

So Galen stated that the first digital bones are flexed with the 
aid of the transverse ligaments, which are authors of flexion of the 
third bone. That seems to me at odds with the truth, on the basis of 
the strength of the first bone’s flexion. For the same reason why the 
tendons flexing the third joints flex the first, those that flex the sec¬ 
ond joints would also be the ones flexing the first because they are 
contained in the same ligaments in the first joints as those that flex 
the third joints. Moreover, the first joints each have two muscles that 
belong to them, by which they perform flexion; but the first joints 


207 Vesalius described Galen’s change of mind in Fabrica II ch. 60 (p. 350, 
misnumbered 250). 


are more weakly flexed than the third. Therefore even under the fixed 
authority of Galen it was neglected by him that the first joints are 
flexed by the same tendons as are inserted in the second joints, ' and 
the second joints also get their flexion from those tendons that are 
implanted in the third, since they are surrounded by the transverse 
ligament no less in the second joint than in the third. 

Galen also neglected to say that the wrist should be flexed by 
these tendons, since they are enclosed by the transverse ligament in 
its groove. So too there are many bones in the foot regarding which 
Galen was lacking if he also wanted bones in which tendons are not 
implanted to be moved by transverse ligaments. Granted, however, 
that when describing the function of the tendons moving the toes 
he was influenced by this reasoning and stated that the tendons con¬ 
trolling flexion of the third joints also move the first and second; but 
at that point everything in Galen is so obscure, and what is written 
in De anatomicis administrationibus agrees so little with what we read 
in De usu partium, that in this part I have never undertaken to decide 
anything definite about his opinion. 

When Galen also ascribes to the muscles moving the wrist the 
function of pronating and supinating the wrist, he is no less mistaken 
than when he states that the wrist is pronated and supinated by its own 
motion. It cannot perform that motion; likewise, the muscles moving 
the wrist also cannot be in charge of that movement. Because in his 
account of the muscles moving the forearm in De anatomicis adminis¬ 
trationibus Galen is so inconsistent with the one contained in De usu 
partium, and because everything in the former book is more true than 
what is in the latter, I shall leave out what is quite useless in De usu par¬ 
tium about the crossing of fibers and many other topics lest someone 
think I take pleasure in chiding Galen and believe I do not, like every¬ 
one in the medical schools, grieve deeply about so great an author. 

But I cannot omit to say what he got wrong when he 
described those muscles in De anatomicis administrationibus, correctly, at 
least, about apes, in describing their function: that is when he ascribed 

to those muscles, which run altogether straight and make no crossing 
or intersection of fibers, such oblique motions . 208 It is not doubted 
that the forearm is not moved by its own motion beyond straight flex¬ 
ion and extension. For if someone flexes the forearm now to the chest 
and now to the tip of the shoulder, the diversity of flexion depends 
upon rotation of the humerus and not upon the elbow joint, which is 
attached by ginglymus and is capable only of simple motion. Thus the 
shoulder joint confused Galen more than slightly in his account of the 
muscles moving the forearm. 

How uselessly he occupied himself in explaining the use of the 
ligament inserted from the ulna into the wrist is clearer from the 
actual makeup of the joint of the wrist to the forearm and the inde¬ 
pendent motion of the wrist, than requires that I should linger refut¬ 
ing Galen’s inaccurate description of that ligament’s function. 

In the muscle controlling the neck of the bladder, because of 
symptoms in the bladder and its neck that have recently come to 
my attention in sick persons, I would like to understand more than 
the smallest amount so that however often I have dissected the neck 
of the bladder, I could subject it to a thorough examination at each 
first onset of symptoms. But so far as concerns the present business, I 
am astonished at how Galen teaches that the same muscle assists the 
promptness of retaining and expelling urine as its particular function; 
but I believe that the better urine is removed when pressed by the 
circular fibers of the bladder and especially by the transverse septum 
with the abdominal muscles, the more the muscle of the neck of the 
bladder opens and the more it relaxes its own fibers. Nothing else 
occurred to me which I could think is the cause of voluntary reten¬ 
tion of urine in addition to the gathering onto itself of this muscle. 166 
What Galen says about the narrowness of the neck of the bladder and 
the urinary passage, and its length and turnings, does not have any 

208 For these remarks about Galen’s errors in describing the muscles flexing and 
extending the forearm, see Fabrica II ch. 46 (pp. 316—19, misnumbered 216—19). 


relevance in women, whose urethra is quite short and runs straight 
downward to its insertion into the neck of the uterus [vagina]. 2 "'" 

Now as the muscles moving the tibia provided a rich abundance 
of discrepancies by which it is shown that Galen dissected apes and did 
not see humans, and as the same muscles have put forward such a vast 
heap of untrue and conflicting descriptions that I have not tried to 
recite them, so too the muscles moving the tibia present themselves to 
those who look uncommonly hard for Galen’s diligence in his account 
of their actions and functions. First in De usu partium, where the muscles 
moving the tibia were described outside the number of the Ancients 
and almost solely from his imagination, Galen taught that the lower leg 
is extended and then flexed but in a triple variety: two oblique flexions 
of which one is inward and the other outward, and one straight, or 
halfway between the oblique movements . 210 In addition, he attributed 
sideways motions to the tibia, by which it is moved inward and out¬ 
ward. There was also an oblique motion, which he assigns superfluously 
to the tibia in De anatomicis administrationibus, by which we move the 
tibia sideways when raising it as if we were moving it toward the other 
tibia. Galen ascribed muscles to these motions, quite contradicting him¬ 
self in De anatomicis administrationibus and De usu partium. But I am not 
going to cite the difference of his opinions, since I wish to show that 
the tibia moves quite differently than Galen says. This part of the leg 
moves only by simple extension, which goes as far as an acute angle, 
and has no oblique movement, as its joint with the femur made by 
ginglymus shows quite fitly. The tibia does not perform the lateral and 
oblique movements declared by Galen in its primary motion but only 
in secondary movement, undergoing every kind of movement at the 

209 See n. 189 above.Vesalius does not distinguish between the vagina and its vestibule, 
where the urethra ends, just as he does not distinguish between the cervix of the 
uterus and the vagina. The vagina was not distinguished as a separate entity until 
Falloppio’s Observationes anatomicae (1561). 

210 “Just as [Galen] made up false motions of the tibia, in the same way he handed 
down to us a muscle fashioned by his imagination.” Fabrica II ch. 53 (p. 335 
misnumbered 235). 

femur in the hip bone, where there is enarthrosis, hke the movement of 
the humerus at the scapula. That this is the means by which the tibia is 
moved to the inside or outside when we flex it is so certain that nobody 
so informed could be in doubt if he has conscientiously taken into con¬ 
sideration the joints and motions of the bones. 

Since therefore my view about the motions of the tibia is so 
different from Galen’s, it is also clear how I disagree with him in 
assigning the function of muscles moving the tibia. But I am most of 
all surprised that the motions of the tibia were not precisely or truly 
observed by Galen, since the function of the muscle [m. biceps femoris] 
which he numbers fourth of those moving the tibia in De anatomicis 
administrationibus is described otherwise in De usu partium, where he 
places it seventh of those moving the tibia, stating that the tibia is 
abducted to the outside together with flexion, and is rolled some¬ 
what inward; but in De anatomicis administrationibus it is attested that 
the entire tibia is moved by it in a simple motion to the outside. I am 
persuaded that because Galen mentions this muscle often, and always 
calls it a wide muscle, believing that it had been torn away in a run¬ 
ner in a competition , 211 he diligently undertook an examination of 
that muscle’s function in apes, and in this way easily observed that it 
moved the tibia only in a simple motion. But since this one reserves a 
more oblique course than the third muscle [m. semitendinosus], which 
Galen says originates from the epiphysis of the hip bone, runs along 
the inner head of the femur, and is inserted in the front of the tibia, 
he wrongly determined that it is the most oblique of all the muscles 168 
moving the tibia. A more oblique course is without doubt that of the 
fourth muscle [ m. biceps femoris], as it runs from the same epiphysis 

211 Galen’s account of the runner is in De anat. adm. 2.298.17 ff.:“In the case of a cer- 
tain excellent runner, we saw this muscle [biceps femoris] ruptured about the middle 
while the man was racing. After that its place was empty and hollow, for the parts 
of the torn muscle had moved, the upper being pulled toward the origin, the lower 
toward the tibia. When pain and inflammation had subsided, walking did him no 
harm and, taking heart, he began running again. Feeling none the worse for this, he 
actually restarted racing and was again victorious.” (tr. Singer 1956, 39 £). 


Detail of the 11th Table of Muscles 
in Fabrica II. The two movers of the 
lower leg most disputed with Galen 
are the semimembranosus (’+'), whose 
origin is marked v; the tendon near 
its insertion in the font of the tibia 
is marked o. The semitendinosus (s) 
has been cut away from its origin (A) 
and hangs from its insertion in the 
tibia. The other hanging muscle (w) 
is the long head of the biceps femoris. 

outward to the outside part 
of the femur and so to its 
outer head and is also inserted 
in the tibia, having the same 
course in simians and humans, 
though in its method of com¬ 
position and appearance it is 
significantly different in the 
former and the latter. 

When Galen argues at 
such length in De anatomicis 
administrationibus about the 
fifth muscle moving the tibia 
\m. semimembranosus ] and is so 
inconsistent in the same page, I wish he had not dissected some other 
muscle along with the third [m. semitendinosus] and therefore missed 
the muscle that I call the fifth moving the tibia. In such a case there 
would have been no disagreement between myself and Galen about 
the function of the fifth muscle. 212 

212 This disagreement is explained in Fabrica II ch. 53 (p. 332, misnumbered 232) in the 
section titled “What muscle Galen calls the fifth, and which one is truly the fifth.” 


But these warnings must be given only in passing, lest I be 
forced to descend into a lengthy description of the muscles and 
recount what I clearly stated on my part in De humani corporis fabrica. 
I wondered there in his description of the sixth muscle moving the 
tibia [m. tensor fasciae latae] that Galen did not consider how by the 
unique workmanship of Nature it acted like a membrane to con¬ 
tain the muscles occupying the femur, and surrounded them like a 
transverse ligament to keep them from being changed in any way; 
but Galen in De usu partium imagined something in place of this 
sixth muscle when he contrived to say that a muscle abducting the 
tibia to the outside originates from the outermost side of the hip 
bone. Perhaps somebody will argue that Galen meant the ilium here, 
unlike the rest of his account of the muscles. But this will again be 
justly seen to pertain rather to descriptions of the muscles than to 
an explanation of their use (as if I should likewise argue that Galen 
had wrongly attested, also in De anatomicis administrationibns, that the 
ninth muscle moving the tibia [m. rectus fern oris] originates from the 

I shall therefore say nothing more about muscles here if I have 
first given notice that I have no reason, based upon close examination 
of the muscle [m.popliteus] hidden behind the knee, to believe that any 
function of bending the back of the knee or the knee can be ascribed 
to it — though Galen sometimes appears to believe that this is the sole 
author of flexion of that joint, or at least that it has the special power 
of setting it in motion; he regarded it with excessive favor perhaps 
because he was the first to observe it or because the Ancients had not 
counted it among the muscles that create motions of the tibia. 

Because something was briefly set down about the muscles 
moving the digits of the feet when I spoke about the muscles of the 
fingers, I will pass them over for the present and add a few things 
about other organs. 

The 1555 Fabrica contains an extensively rewritten description of the m. semimem¬ 
branosus and Galen’s errors concerning it. 

Places collected from the description of veins, arteries, and 
nerves where it is known that Galen consistently assigned 
incorrect uses and actions 

It is not entirely to my liking that Galen attributed to the portal vein 
the power and faculty of preparing juice to be supplied from the 
intestines to the liver in a way that is extremely similar to the func¬ 
tion of the liver itself. For though I am not forgetful of our common 
opinion about the settling of urine, I cannot persuade myself how 
the power of making blood can exist in a white, thin, membranous 
body; and if some power of digestion were present in a vein besides 
that which all the parts possess for preparing their own nourishment, 
it would certainly have created a white humor rather than blood. 
If someone called my attention to the proximity of the liver to the 
whole length of the vena cava, I would like him to see that Galen was 
so forgetful in De placitis Hippocratis et Piatonis of what he had written 
elsewhere and so excited about arguing with Aristotle that he denied 
the power of sanguification in the very short interval of the vena cava 
that is seen between the liver and the heart.- 1 ' 

That paradox has a bearing on branches of the portal vein 
170 extending to the place where I stated that thick, melancholic blood 
flows out of the anus at intervals, more through those branches than 
through offshoots of the vena cava. I made that statement in the Epistle 
that states, among other things, chiefly that it makes little or no differ¬ 
ence which vein of the forearm is opened in the lateral disease; or if 

213 See Fabrica III ch. 5 (p. 367, misnumbered 267): “I can assign no power of sangui¬ 
fication to the membranous and leathery body of a vein; if there were, it would 
surely make a white blood, just as substances transformed by the stomach resem¬ 
ble a milky color like the white substance of the stomach. Clearly we do not see, 
as in the liver, that it is red like congealed blood. I would refute this oft-repeated 
view of Galen at greater length, were it not that Galen himself changed his mind 
in the sixth book of De placitis Hippocratis et Piatonis, forgetting himself so as more 
sharply to dispute Aristotle.” Galen said in De usu partium that the veins have a role 
in sanguification. 


it makes any difference, that the vein of the right forearm should be 
cut, whatever side or whichever part of the thorax the inflammation 
attacks. 214 

In the description of nerves, as on many other topics, I am quite 
surprised at the question commonly put in the medical schools which 
is taken from the first book of De locorum affectorum notitia 215 where 
it is disputed at length and with all kinds of arguments how move¬ 
ment can be lost while sensation remains, and how when motion is 
preserved sensation is lost, the entire disputation being made always 
about the ring finger and little finger. Here they all say first that a 
greater amount of animal spirit is required for motion, and therefore 
when that spirit is lacking it can easily happen that when motion 
is lost sensation is still to some degree unaffected. But the reason 
does not so readily appear how motion survives after sense has been 
lost. Galen appears to have made a distinction so that he could say 
that some nerve twigs are responsible for motion and some for sen¬ 
sation, as if a nerve occurred that lacked a sense of touch. 216 I can 
for no reason subscribe to this opinion, especially because for one 
trained in the dissection of nerves and muscles there is no need to 
take refuge in that false axiom to teach that motion is preserved 
without sensation, especially in the fingers about which Galen made 
his argument. If one knows that what I count the fourth nerve [n. 
mdialis] of those that enter the arm provides twigs not only to the 
muscles that most extend the fingers but also to many other muscles, 
he will also be aware that it does not go to the ring finger and little 

214 See n. 184 above for the afflictions identified as dolor lateralis .The 1539 Venesection 
Letter in fact states clearly that “In all inflammations of the sides of the thorax or 
of the thoracic vertebrae, the right axillary [vein] must be cut” (Venesection Letter, 
p. 56, tr. Saunders & O’Malley 1947, 82) — though it appears here that Vesalius has 
changed his mind. 

215 Also known as De locis ajfectis. 

216 It was in fact Herophilus of Chalcedon (c. 330—260 BC) who first distinguished 
motor from sensory nerves. 


171 finger as it does to the others with offshoots to their outer side, 
but that those two fingers receive twigs on both the inside and the 
outside from the fifth nerve [n. ulnaris] entering the arm. He would 

be able to damage the fourth 
nerve in the back of the upper 
arm or in the elegant complex 
of nerves near the sides of the 

The “elegant complex of nerves” 
leading to the arm from the cervi¬ 
cal vertebrae, from the beginning of 
Fabrica IVch. 14. The radial nerve 
is labeled D; F is the ulnar nerve. 

cervical vertebrae, or learn that it had been bruised or crushed while 
the fifth is still undamaged: he would immediately notice that sen¬ 
sation had been lost to the little finger and the one next to it, but 
their extension is not spoiled. Again, if he imagined the fourth nerve 
unhurt but the fifth damaged, the function of the muscles extending 
the fingers will not be lost but sense in the little finger and the ring 
finger will be absent. The truth of this proposition (if it ever turns 
out to be true) must be sought from careful dissection rather than an 
imagination whereby we suppose that nerves lack a sense of touch 
contrary to the nature of nerves. 

But whenever this widespread and too common question is 
raised we must think about the flow of humors in the nerves rather 
than its division, since the latter would deprive the entire nerve of 
sense while the flow of humors sometimes indicates the first dam¬ 
age in the farthest twigs of a nerve, however deep the nerve itself 

But it is not my intention to write you, my dear Joachim, 
about such distinctions that must be declared in academia for us to 
dispute for the sake of sophisms: you have enough erudition and 


sharp judgement to know immediately the opinion to which I am 
speaking and to understand that my effort is not for a beginner in 
our craft. 

A description of some things that are contained 
in the peritoneum 

To say nothing about the function which Galen provides to the 
peritoneum of preventing the intestines from coming between the 
muscles that he upon them, I cannot imagine how the peritoneum 
also performs the functions of the nearby transverse septum as an 
aid in expelling feces more than as a skin cloaking the abdomen or the 
omentum, or as fat lying beneath the skin. While Galen ascribed this 
function to the peritoneum, he should also have considered how by 
the same token he should have attributed to the membrane covering 
the ribs the capacity of compressing and narrowing the thorax. 

Galen and everyone who wrote about anatomy after him attrib¬ 
ute a glandular body to the lower orifice of the stomach by which 
they think it is contracted; 217 some of them also add to what they 
wrote that this body surrounds the orifice like a kind of muscle, and 
has a function similar to the neck of the bladder or the muscle of the 
anus. I am certainly aware of a long glandule next to the duodenum, 
similar in substance to the body that is placed on the lower membrane 
of the omentum and takes its name from a type of meat and its good 

217 The pancreas, whose alleged function was previously discussed on p. 133. In the 7th 
ch. of Bk. 4 in De usu partium Galen writes “In many animals something of a glan¬ 
dular nature is found at this point [the pylorus], which increases the constriction, 
particularly when the stomach exercises its retentive faculty and is actively engaged 
in digestion, gathering itself together, contracting, and clasping and compressing its 
contents (3.280.18—281.5, tr. May 1968, 211, who notes “This is a puzzling state¬ 
ment and there is nothing to explain it in Galen’s other works. Could he have been 
thinking of the head of the pancreas? But if so, why the qualification ‘in many ani¬ 
mals’? In the rhesus monkey the folds of the mucosa in the pyloric canal are high 
and distorted ... and this feature may be what was in his mind,” etc.). 



looks. 218 But it is perfectly clear to me that this glandular body is not 
responsible for closing or opening the orifice of the stomach, but is an 
elegant support and bolster for the vessels running lengthwise along 
the intestine; it would therefore not seem worthy of an anatomist to 
put this gland in charge of excretion which is natural and not subject 
to our will. 

I do not know whether it was taken from Galen somewhere that 
the upper orifice of the stomach is closed by the transverse septum 
by means of its foramen by which it transmits the esophagus, because 
people declare that it also prevents the upward regress of food; they 
do not observe that if their statement were true, that foramen of the 
septum would no less block the entry of food into the stomach. It is 
easily known that we have no motion in the orifice of the stomach 
that depends upon our will. 

Concerning the function of the spleen, the natural purging 
173 of impure and black blood into the stomach and of what would 
become single products of digestion (as we believe happens with yel¬ 
low bile), and about constriction of the upper mouth of the stom¬ 
ach, I am no less uncertain than I was when I published my book 
De humani corporis fabrica. I am perfectly willing to have it blamed on 
my ignorance that I do not find the passage or vein that spews the 
black juice 212 into the upper orifice of the stomach rather than into 
the rest of the left side of the stomach. I do not say this as if I thought 
a long discourse should be commenced here about the functions of 
the spleen, but so you would understand that I am still in the same 
way of thinking and still more that I have doubts about the common 

218 Gk. TrdyKpsas, “all meat” and KaAAiKpsas “beautiful meat” because it was 
favored as a food; cf. Engl, “sweetbread.” On this organ, see Fabrica V ch. 3, the 
section titled “Glandular flesh standing not far from the lower orifice” (p. 491, 
misnumbered 391). 

219 The mythical black bile that accounts for melancholic personalities and constitutes 
one of the four humors.Vesalius has reverted to this subject several times already in 
this work. See pp. 133, 135, 138, and 221 and notes 174, and 181. On the spleen, 
see FabricaV ch. 9. 


opinion of physicians even since I inspected the spleen ofBelloarmato 
of Siena, the great jurisconsult at Pisa, which beyond doubt had for a 
long time performed the function of his liver. 22 " He had greeted me 
in a bookshop to which I had gone in the afternoon with my students 
when my lecture on dissection was completed, and he had been asked 
some questions about his health, which had been poor for many years. 

In that conversation I mentioned obstruction in passages of the liver, 
the gall bladder, and finally the spleen as well; he said that the next day 
he would come to the anatomy and closely observe the organs whose 
construction was due to be explained. When he went home from the 
bookshop and occupied himself with his studies for a few hours, soon 
after beginning his supper he was overcome with a strange weakness 
of body and shortness of breath. After several remedies which were 
considered appropriate for the flow of bile into the stomach were 
tried by doctors who knew him, he expired. Because his body was to 
be transported to Siena and placed in the family tomb, his family and 
friends asked a surgeon that his organs be removed. 

When he proposed this task to me in the beginning of the 4 
morning, I was quite eager to learn the cause of such a sudden and 
unexpected death in such a famous man. When I dissected him, I 
immediately found all the blood in his body to be still quite warm 
and to have collected as I have sometimes seen water collected there, 
in the peritoneal cavity, an accumulation under the skin which we 
know takes its name from a skin water bottle." 21 A hardened abscess 
in the stem of the portal vein had provided the occasion for this flow 
of blood; the abscess had suppurated in one place and broken, giving 
the blood a path. So as soon as I had removed the brain and all the 

220 On Marcantonio Belloarmato and the ailments that led to his death, see O’Malley 
1964, 202,451f. 

221 Lat. uter. Cf. FabricaV ch. 2: “Like wine sacks [utres] made from skins that are usually 
hairy and rough on the outside and smooth and even on the inside, the peritoneum 
appears rough and fibrous on the outside to adhere better everywhere to muscles, 
in exactly the way we say that membranes attached to each other are uneven.” The 



viscera, and thus prepared the remaining body so I believed it would 
be less tainted and freer from putrefaction, I had his liver, gall bladder, 
stomach, and spleen transported with me to the university to exhibit 
as a great proof of bad health. 

We saw that the liver was quite pale, like the inflated lung of a 
pig or a dog. Its surface was not smooth but quite uneven and rough¬ 
ened by many smooth tubercles. On the hollow side of the liver, all 
the branches of the portal vein were plainly visible after the substance 
of the liver had been fully retracted or pulled away from the lower area 
of branches. The anterior part of the liver and the entire left side were 
hardened like a stone, but the back where the stem of the vena cava 
stands was quite soft and appeared damaged by decay. 

The gall bladder was also paler than normal and contained eigh¬ 
teen small stones, quite smooth and shaped like a triangle with sides 
and surfaces that were everywhere equal, green and blackish. When 
dried they appeared more ashen, in size like chickpeas. 

The spleen, for whose sake I am chiefly writing this, was quite 
large, displaced to the front of the body, soft, and a little whiter than a 
natural spleen. To put it simply, no one was found in so large a crowd 
of extremely learned spectators who would not immediately state that 
the spleen had indubitably functioned in this man in the role of the 
liver, and his liver appeared for a long time to have had no share in the 
role of sanguification. Meanwhile, the spleen had grown to the size of 
the liver and was modified also sufficiently to produce blood, so far as 
we could gather, in the degraded constitution of his body. And since its 
veins extending to the stomach from the vessels closest to the spleen 
were quite large, I also advised the students to observe carefully whether 
a vein was inserted as far as the mouth of the stomach. But in the vein 
that came closer than all the others to that orifice, we found no differ¬ 
ence from that of other humans except in size. Like all the others con¬ 
nected to the left side of the stomach, it was by far the largest. 

term survives in modern anatomy only as the diminutive “utricle,” a minute pouch 

in the prostate. 


I also dissected Prospero Martello, the Florentine patrician (who 
for many years had suffered from jaundice and like Belloarmato had 
died a sudden and unexpected death). When I was about to leave 
Florence and was riding past his palace in company with Francesco 
Campana, chief private secretary of the Duke, I was called upon by 
certain gentlemen to investigate the cause of death with a number 
of surgeons who had already begun the task. Death had been caused 
principally by an injection of bile into the stomach, which was swol¬ 
len with pure bile, accompanied by hard swelling of the liver and its 
contraction or condensation into one. The spleen, however, was softer 
and larger than normal, and appeared to have functioned in preparing 
blood; but the gall bladder was easily the size of two fists and full of 
something like tiny pebbles, which were connected together and 176 
were very like grains or seeds of millet, or rather the rough surface 
of the common tutty 222 of the pharmacies. Wherever I opened the 
veins, I found nothing but very thick bile, and indeed the fluid in 
the arteries stained my hands no less than the bile itself. I have reviewed 
these facts so you may understand why I am in doubt about the func¬ 
tion of the spleen and why nothing is ready to be revised in my 
account of it in my book. As the Gods love me, I therefore have found 
nothing written there, especially where I have cited Galen, where I 
believe anything unreasonable has been included, however carefully 
I reviewed them after publication and the Geldric war 223 from which 
I returned to Italy and performed public anatomies at Padua, Pisa, 
and to a degree at Bologna when I was about to set out from there 
to Pisa. I could not fail at the urging of friends to dissect several parts 
which were ready at hand there in an anatomy when the business had 
run late into the night; Buccaferreo of loving memory and Albius (to 

222 Medieval Lat. tutia, an oxide of zinc used medicinally in astringent ointments and 
lotions (OED). 

223 Gelderland, a duchy of the Holy Roman Empire, became part of the Habsburg 
Netherlands in 7 September 1543 following the siege of Diiren by Charles V and 
the Treaty ofVenloo. 



both of whom I owe much for their singular candor toward me) were 
eager for me to do this, together with a large number of students who 
were present. 

I had also examined the organs of the Prince of Orange, Seigneur 
de Hallewyn, 224 and a number of others whose bodies were injured 
in bombardments and had to be removed by someone from our army. 
I never thought the opportunity would be lacking to examine the 
things of which I shall be reminded, though I should rather per¬ 
suade the disciples of Sylvius and Sylvius himself to consider carefully 
everything I say before attempting to disprove or condemn them from 
my book alone — lest they prematurely remove the opportunity for 
students to investigate the truth. I am not one to believe anything 
human is alien to me, 22 ’ nor am I unaware of the steps in which I 
have learned the fabric of the human body by teaching others and by 
writing. In this regard I acknowledge no preceptor whatever, nor do I 
believe if I say so that Sylvius will later take offense, if while he attests 
that Galen made no error I loudly contradict him so many times. 
Sylvius also writes that no matter how much attention he pays me he 
will not keep me as a friend unless I hold the same opinion he does 
about our common preceptor Galen. No one should therefore expect 
great praise from me for Sylvius nor wish me ill because I do not 
consider him magnificent among the professors of anatomy. I must 
acknowledge that all who follow Galen today have the same view as 
Sylvius and have passed it along in their books, if they have not also 
sometimes misrepresented Galen, never noticing an inconsistent place 
in his writings. As least on the basis of what I have written here, it is 
quite clear that many discrepancies exist in Galen’s books. 

224 Jean III van Halewyn (1510—1544), casualty in the siege of Saint-Dizier, France, 23 
July 1544. See O'Malley 1964, 206,452 n. 80.Vesalius misspells his title Arangia and 
his name Haluin. 

225 From Terences famous quotation (Heauton Timorumenos 77), itself a tag from 
Menander, Homo sum: humani nil a me alienum puto. 


I could not therefore be sufficiently astonished by the letter of 
Dryander shown to me at Cologne by our common friend the promi¬ 
nent doctor Ioannes Eck when I recently traveled there, 226 in which 
he complained that I had made no list of the celebrated professors of 
anatomy of our time, and that in addition to a number of others (I do 
not know whether they were ever born) I had not mentioned Ioannes 
Guinter in this way as my preceptor: 22 I certainly respect him among 
many names, and for his public writings as a preceptor of medicine. 
But I wish as many cuts made in me as I have seen him make in a 
human or another animal (except at the dining table). I do not think 
Guinter objects to that since it is known to him and many others 
whether he owes anything to me in this part of our craft, if in fact he 
claims anything for himself in the method of dissection beyond the 
common books of Galen. 

But Dryander brings forward this person, perhaps thinking he 
himself has been wronged because he was not named in a list of profes¬ 
sors and because he is unhappy that I censured him when I wrote that 
someone at Marburg was publishing figures taken from the books of 
others wherever they were, as if they were his own. 228 1 never thought 
that Dryander, of whom I previously held a different opinion, was pub¬ 
lishing the anatomical books which I believed printers had brought 


226 August 9—17,1545; see O’Malley 1964,210,221,453 n. 104. Eck was a physician from 
the Netherlands who practiced in Cologne and had a special interest in botany 

227 Johan Guinther (or Winter) of Andernach (1505—1574) lectured on anatomy at 
Paris when Vesalius studied there and was assisted by Vesalius. His Institutiones ana- 
tomicae (1536) anticipated Vesalius’polemic against physicians who were ignorant of 
anatomy, but its anatomical content was purely Galenic. See O’Malley 1964, 54ff. 

228 Identified by Choulant 1920, 148 f. and Cushing 1962, 28—32 as Johannes Dryander, 
alluded to in Bk. 2 ch. 7 as a “certain mathematician” who misrepresented the saw 
best suited for cutting the bone of the skull, and more courteously by name in Bk. 5 
ch. 4. He was appointed professor of mathematics and medicine at Marburg in 1535, 
and his Anatomia capitis humani (Marburg, 1536,1537) was one of the first illustrated 
anatomy books. In 1541 he had plagiarized the illustrations in Vesalius Tabulae sex 
(1538). He is mentioned as a plagiarist without being named in Vesalius’ Letter to 
Oporinus at the beginning of the 1543 Fabrica as one “who is still indiscriminately 
compiling pictures from other people’s books everywhere and publishing books of 



out in both Latin and German for the sake of sordid cash, borrowing 
his name (to make their own work more salable). And if Dryander 
had been the author of those books (as even he now persuades me he 
was) and gave me no reason why a list of celebrated anatomists of our 
time should have been put in the preface of my book when he himself 
should be content with common censure, I too must likewise endure 
it that like many others he resents Vesalius for the things many have 
now written about me and rejoices that Cornarius 229 will soon cor¬ 
rect Galen and Aristotle in all passages where I have criticized them. 
Dryander remarked in the same letter to Eck what needed to be done 
especially by one who is eager to be numbered among anatomists and 
surgeons. Cornarius should abandon the labors by which he is carry¬ 
ing forward their common interests, especially since this correction of 
Galen is not to be sought from his books or those of others, but from 
the diligent and careful dissection of humans, simians, and certain other 
animals. Nor is it sufficient to occupy oneself in speaking ill of some¬ 
one or ridiculing the efforts of others and to detract equally from one’s 
own and others’ glory (while so few are laboring to do credit to their 
studies), when one should rather be working up a sweat in common 
efforts at the truth, and believing that we too were born human. 

Something in the vast art of medicine may be present in us, as 
well as a faculty of discovery, if we are more strongly held by a desire 
for truth than for calumniating others. 

With these thoughts, I regret the fate of Cornarius and Fuchs 2311 
that they have damaged their otherwise celebrated name when they 

that kind at Marburg and Frankfurt.’’Vesalius referred obliquely to Dryander again 
near the end of the 1555 Fabrica I ch. 5. 

229 “Primarily a medical philologist who edited a number of classical medical texts 
including works of Hippocrates, Galen, Aetius, and Paul of Aegina and belonged 
to that group of physicians who, because of their strong and constant belief in the 
validity of classical authority, were naturally unsympathetic to Vesalius s purpose.” 
O’Malley 1964,456 nn. 178 and 179. 

230 Leonhart Fuchs (1501—1566), German physician and author of De historia stirpium 
commentarii insignes (Basel, 1542), which made him one of the founding fathers of 


harass each other with such wrangling when they should judge each 
other a singular credit to Germany abroad, and proceed to exhaust 
among themselves hostile energies that should have been employed in 
praises of Germans and Belgians. 

Since I blame this behavior on the unhappy failings of mortals 
and believe we ourselves open the window to such reproaches upon 
ourselves, lest I be distracted by another ignoble passion and let myself 
digress further, I shall return to Galen. When he inquires into the cause 
of the beginning of the vessels delivering material to the left testicle 
(both of which he stated inaccurately originate from the vessels that go 
transversely to the left kidney), and asserts that all the stimulation and 
pleasure in the ejaculation of semen depends upon the large amount of 
serous humor which these vessels supply, he seems to me not to have 
observed that men whose left testicle has for some reason been severed 
have the same experience in coitus as those whose right testicle we 
know has been removed. It is surprising that in urinating we do not feel 
the stimulation that we feel in the ejection of semen; however, where 
we experience the strength of the semen in the tip of the glans and the 
perineum, the same path is made for semen and urine; therefore when 
a man is healthy this passage is no more disturbed by the saltiness of 
urine than the bladder. And since we urinate sometimes when the penis 
is more flaccid and sometimes more rigid, we do not have recourse 
to the heating of the penis making it more sensitive to the quality of 
urine. Those beginning to suffer from an involuntary flow of semen 
perceive the excretion of semen with the itch of desire and stimulation 
even if ejaculation takes place from a flaccid and lowered penis. 

From the description of parts located in the thorax and skull 

The tip of the heart is quite thick and fleshy not to prevent it from 
being moved into the breast bone and damaged during contractions 

botany. He and Cornarius carried on a well-known feud, as this remark ofVesalius 


of the heart, since it is clear that it is not bruised in this way; in fact, 
the nature and combination of fibers and flesh of the left ventricle 
show clearly enough why the tip of the heart turned out to be so 
thick and fleshy 

I wish Galen had observed in the ventricles of the heart that 
nearly the entire substance of the heart is taken into the makeup 
of the left ventricle, while the right is attached to the left like a 
crescent moon. The substance of the heart thus forms the right side 
of the left ventricle so that it protrudes to the right and keeps the 
same circumference and periphery as the remaining surface of the 
left ventricle. 

But if I brought many of these things into consideration, an 
end to my writing would not appear quickly in my account of func¬ 
tions, and I must now hurry to conclude if I am to add that I am 
not entirely satisfied with Galen’s reason why he determined that 
the cerebrum is in two parts: so that if one side of it was damaged 
the other would perform its function, in the same way that if one 
ear is stopped up we can still hear or if one eye is blinded we will 
still see with the other. Since the cerebrum is continuous for such 
a large area at its base, and then in its other bodies which are called 
by their own names, Galen should have mentioned the division of 
the cerebrum for suitable nutrition, as I have sufficiently shown that 
the convolutions of the cerebrum were made for its nutrition. It is 
clear how Galen thought about the uses of the cerebral ventricles 
when in discussing the excellence of the ventricles in De placitis 
Hippocmtis et Platonis he says the exact opposite of what he said in 
De usu partium . 231> k 

If one has observed the processes of the cerebellum [vermes cer- 
ebelli] which we compared to worms, and then makes an examination 

231 Galen “taught in the third book of De placitis Hippocratis et Platonis that the middle 
ventricle was the main one, while in De usu partium it was the rear ventricle.” 
(.Fabrica 7 ch. 6). 


of the nature of the cerebral ventricles, Galen will seem ridiculous 
for writing that the processes imitating a worm are responsible for 
opening and closing the cerebral ventricle. As the function of these 
processes is badly assigned, so also Galen is not to be believed about 
the tendons that he says contain the wormlike process on each side 
and prevent it from slipping to the sides when it is contracted or 

Many such remarks occur in De usu partium which indeed seem 
elegantly written and appear to set forth the great intelligence of the 
supreme Maker. But when one considers everything on the basis of 
careful dissection, he will not be able to wonder sufficiently how 
Galen like a Prometheus was able to invent a fabric of the body and 
uses of its parts which are quite foreign to the constitution of man. 
Likewise, whatever was said by Galen about the drainage of phlegm 
through bones and the organ of smell (as I explained earlier about his 
untrue descriptions) is known to conflict with the truth. 

Some invalid anatomical proofs of Galen are mentioned 

Next we shall weigh Galen’s rigor in proofs and demonstrations, citing 
several proofs as examples (as we did before in other familiar places). 
Because there is little doubt that fat attaches to ligaments and mem¬ 
branes, and everything altered by the task of nutrition in our body 
assumes the color of what changes it, I believe that fat becomes white. 
This is not because it is like air; for otherwise membranes, tendons, 
ligaments, and still more, bones, would be black, being the driest, most 
terrestrial, and least airy parts, but they are nevertheless white and 
take on the luster of fat. However, if I began to set forth an example 
of proofs especially relevant to anatomy, I would never do better 
than go to the vena cava, which Galen argues against Aristotle origi¬ 
nates from the liver and not from the heart. In this matter I would 
not like anyone to think that I have set limits on something, but only 



that certain reasons of Galen have been examined to prevent anyone 
imagining a false fabric of the human body because of them. 

In the sixth book of De placitis Hippocratis et Platonis where the 
origin of the veins and the principal home of the nourishing faculty 
are described, several passages occur that are relevant to this topic. 
When Galen is about to discuss the origin of veins, he applies three 
proofs to a single axiom, that larger, wider things are the beginnings 
of smaller, thinner ones. 232 The first proof is taken from plants, whose 
beginning Galen determines is from their procreation out of a seed. 
Where they are thickest and where, when the seed swells with mois¬ 
ture and air and breaks out in the earth, we see it sprout something 
upward and down. When the part that goes upward has grown like 
a tail for a period of time and then split into many branches, unless 
the variety of the plant calls for immediate ascent, it is split variously 
into several parts. Galen therefore determined that the plant’s begin¬ 
ning depends upon the point where the roots are seen and the plant 
is borne upward. That must be conceded to him, since however it is 
fashioned he derives the middle term of the syllogism in this reason¬ 
ing from Aristotle rather than himself. 

232 For this analogy, see De placitis Hippocratis et Platonis ff.: “Just as plants 
draw all their nourishment from the earth through their roots, so the heart draws 
air from the lungs through the arteries mentioned. These two very large arteries 
have grown out of the heart, each from its own shoot. And as in the plant the part 
that projects from the earth, the stem or trunk, is the widest of all its parts, and 
the part that divides off into roots is the widest of all the lower parts, and the part 
between them is the source of the plant, in the same way the largest artery is like 
the crown of the root for the animal as a whole, and the artery that has its inser¬ 
tion in the lungs is the largest of all therein, while the heart is between the two 
and the source of the faculties controlling them. In man, being of a more formi¬ 
dable nature beyond what has already been said, it is clear that things greater are 
sources of things smaller, just as the spring is the source of the streams to which it 
is distributed. Yet some have been so illogical as to think that what comes after is 
greater than the source, being misled by rivers that are quite small at their sources 
and are increased as they move along. But this is not necessarily always the case.” 
(tr. De Lacy 1981,377-379). 


For the same reason we cannot contradict Galen here or in his 
book De semine, where he stated that this was at once the effective 
and material cause of the fetus and that at one time the substance of 
the seed is changed into a plant — even if we see that when the new 
offshoot is separated from the lower part of the seed and strengthened 
in the manner of roots and the entire seed with its hull is cut apart 
below, it is taken from the ground and soon the divided hull falls 
away. Then two kernels or parts of the seed grow into a new plant on 
each side and afterward become green so long as the new plant bears 
leaves and its kernels or parts of the seed dry up and fall away. The 
small appendage that stands in the tip of the two parts of the kernel or 
in certain seeds such as peas and beans is located at about the middle 
of their side, is seen not to degenerate into the substance of the plant, 
especially when a seed removed from the ground has already begun 
to grow and nothing from its form (except for its size) and much less 
from its substance has been lost. 

A second argument from Galen to inform us that the origin 
of the vena cava does not come from the heart is based upon rivers, 
which are seen to be greater in their beginning than in the rest of 
their course; here he warns us at the outset that we should not think 
of rivers which are increased by the influx of other springs or rivers 
and easily in their progress surpass the size of their beginning: we 
should imagine a stream with only a single source that takes on no 
increment as it goes but scatters into branches and becomes thin like 
veins passing from their stem. 

A third argument is taken with great elegance from other organs 
in man that remove something from the body. Arteries have a stem 
coming from the heart, which is then divided variously through the 
body. The dorsal medulla is also like a stem from which nerves sprout 
like limbs on a tree. 

As soon as Galen has established with these three arguments that 
greater things are the beginning of lesser, he immediately sums up; but 
the vena cava is largest and widest in the liver, so he then easily infers 



that the beginning of the vena cava must be established in the liver, as 
the place of the vena cava resembles the trunk of a tree, the beginning 
of a stream, and the origin of arteries; it could also be compared to 
the dorsal medulla. 

Thus the minor proposition 
showed Galen nothing relevant, since he 
believed everything in anatomy could be 
fashioned as he liked it. He asserted that 
the vein in the liver is as large as the size 
of its ascending part and its descending 
part combined, and wrote that the vena 
cava is borne straight along the liver, fol¬ 
lowing the opinion of Hippocrates, who 
was more thorough in this part than 
he was. Unlike what he said elsewhere, 
when he attests that its largest stem orig¬ 
inates from the hump of the liver in the 
same way that the great artery proceeds 
from the base of the heart, and when 
it is split into two unequal parts, Galen 
teaches that the vena cava is divided into 
a greater portion which goes downward 
and a lesser which is taken upward. After 
he has described the size of the vena cava 

This detail ofVesalius’ diagram of the veins 
preceding the 6th chapter of Fabrica III shows 
the ascending and descending vena cava. D 
marks the large orifice of the vena cava opening 
into the right ventricle of the heart; three A’s 
mark the branch distributing offshoots to the 
left side of the liver. F, F is the azygos vein, 
seen originating above the heart. 


at the liver, he says that the vena cava reaches the heart as if it were 
offering it only some branch. When he states in this work that the 
ascending part of the vena cava above the liver is narrower than the 
descending so as to add strength to his reasoning there, he teaches that 
many veins from the vena cava originate between the heart and the 
liver, chiefly to perform the function of the azygos vein. 

Because such statements occur in Galen, much against the liking 
of philosophers I provide an occasion for them to argue with reasons 
taken from here that Averroes 233 defended Aristotle in everything for 
which he is criticized by Galen; I could not fail to warn students 
while teaching and in my book that the vena cava extends to the 
heart with a larger orifice than its size in the liver. In fact, this orifice 
has a capacity equal to the volume of the descending and ascending 
parts of the vena cava, far from being smaller than the ascending part 
of the vena cava above the heart, as Galen obviously believes contrary 
to the truth of the matter. So in the present body we should, unlike 
Galen himself, subordinate his lesser propositions to his greater ones 
according to true anatomy, and then apply them to Aristotle’s opinion. 
It is well known that in this part of the body Galen’s arguments are 
quite ineffectual; we have also shown above that without any reason 
he makes the part of the vena cava between the heart and the liver 
narrower than what is below the liver. It is also perfectly clear that the 
azygos vein and many other offshoots were inaccurately described by 
Galen in De placitis Hippocratis et Platonis as originating beneath the 

I am not only astonished at so many false propositions of Galen 
that he makes to prove his doctrine, and his fictions in anatomy; I am 
also amazed at the argument that he introduces regarding the course 

233 Abu al-Walid Muhammad ibn Ahmad ibn Muhammad ibn Rushd (1126-1198), 
known in the West as Averroes, worked during the last years of Muslim rule in Spain. 
In addition to the Colliget, a summary of medicine published in Latin in 1527, he 
wrote Commentaries on Aristotle, which, was widely admired by Christian Scholastics 
for its argument that religion is compatible with science and philosophy. 

21 7 

of the vena cava to the base of the heart, stating that if the vena cava 
originated from the heart like the great artery, it would be split into 
two trunks so it could conveniently be carried upward and down. 
This is such bad anatomy that it is scarcely anatomy at all. The great 
artery originates from the middle of the heart’s base and is necessar¬ 
ily taken upward at its stem until it can divide off its largest part. This 
curves back along the back of the heart to the spine and is distributed 
to all the parts beneath the heart. It was therefore very opportune and 
necessary to the artery, which otherwise needed to originate from 
the middle of the heart’s base, to be taken for some time with a single 
stem no differently than the arterial vein [truncus pulmonalis ], which 
because it also comes forth from the middle of the heart’s base and 
not from its side, is borne for some distance with a single stem until 
it is divided into two trunks. The venous artery [vena pulmonalis] is 
brought out from the left side of the heart’s base with a single orifice, 
but immediately after its beginning it is split into a right and left half 
so that many anatomists, if only because of Galen’s testimony, ascribe 
186 two orifices to it, for it would have been quite awkward for a ves¬ 
sel originating there to be borne for some distance with a single stem 
because a portion is to be presented to the right lung. 

Now the vena cava, extending with its orifice to the right side 
of the heart’s base just as the venous artery extends to the left, even 
if it originated from the heart there, would not have needed to be 
borne for some distance with a single stem before being split into a 
part going upward and another that goes down. That is because as the 
vena cava is now arranged it is taken more or less obliquely along the 
heart so that its stem will be able to stand in the middle of the body; 
it would have been crude and without any skill in creation for a sin¬ 
gle stem to be borne still more to the right and then have its trunks 
directed to the left towards the middle of the body . 234 

234 The illustration of the inferior vena cava made for the 1543 Fabrica and reproduced 
above does, however, show such a detour to the right and back to the left. By now, 
it seems,Vesahus realized no such curvature exists. 


As I previously warned, Galen attests that the vena cava proceeds 
with a single stem from the liver and is then divided like the great 
artery. Yet elsewhere because of Hippocrates’ account, which taught 
that the stem of the vein runs straight up and down, he would appear 
to have abandoned that view. But however that may be, the stem of 
the vena cava does not show itself differently in the back of the liver 
than the way I described it, which is quite different from the way 
Galen is seen to have described it, whichever of the conflicting pas¬ 
sages of his we have judged the truer one. Although he did not write 
elsewhere that the vein is split in two, he did say everywhere that its 
orifice in the liver equals the size of both its ascending and descend¬ 
ing parts. If he had been committed to dissection rather than his zeal 
for condemning Aristotle, he would have preserved the utmost truth 
about the orifice of the vena cava at the heart. 

I find nothing weaker than the argument put forward by Galen 
about the right ventricle or cavity of the heart, which animals without 
a lung do not have, as if Aristotle, or those who have said the vena cava 
originates from the heart, had not said that about animals that have 
this ventricle; and they wrote no differently about these animals 
than about those in which there is no right ventricle. Galen should 
not have made this cavity a cause of objection against Aristotle; it 
should rather have been explained that the vena cava is provided with 
one cavity into the heart, not that it sends off an offshoot. I do not 
think Galen altogether believed that the heart of those animals was 
completely lacking the offshoot, since their vena cava is connected to 
the base of the heart just as it is in those animals that have two ven¬ 
tricles. For this reason Galen’s logic is not very sound. 

When he makes all veins common to the liver and not the heart, 
what, I beg to ask, is common to the liver with the arterial vein \trun- 
cus pulmonalis ]? Or, if you deny that this is a vein because it has an 
arterial body, at least the venous artery [vena pulmonalis] no less meets 
the liver than the portal vein meets the heart. What he brings forward 
about the description or account of the veins is a rhetorical argument. 



Indeed, if we had not been swearing in this way by the words of 
Galen, 2 ” perhaps I would think it more opportune to begin from the 
heart in my account of the series coming from the vena cava, whose 
orifice we have said is the largest of all that open into the heart, just 
as I do for the other vessels of the heart. What would keep us from 
saying that the vena cava is a double vein immediately upon its origin 
from the heart, and that with one portion it goes to the upper body 
and with its other the lower? If the account is begun there where it 
is largest, we could then add that the part going downward is borne 
along the back of the liver and extends branches to the liver from its 
anterior side. Chiefly for this reason the account would appear more 
fitting, because we cannot describe the makeup of the vena cava from 
the liver, as I explained at length above. Although one should always 
begin from the progress of the material which they deliver, since the 
portal vein provides so much juice to the liver from which blood, 
both kinds of bile, and urine result, its description should begin 
from the intestines: for the blood which we believe flows back into it 
is in no proportionate measure with that juice. But these are of such 
a kind that can be carried into both parts. The calculation could be 
weakened to some degree by the membranes controlling the orifice 
of the vena cava as compared to the orifice of the venous artery, if one 
proposes to bring every small factor into the argument. 

I would add something about the umbilical vein, if I had exam¬ 
ined the vein leading into the mesentery of a canine fetus and into the 
loins in a human fetus. A calculation could be taken from this and the 
umbilical arteries to show that it was not necessary for the umbilical 
vein to be inserted in the heart, since it is more closely shared with 
the vena cava at the heart than the fetal artery is to the great artery (as 
even now is always the case). 

Because the venous artery does not pulse anywhere in its course 
like arteries, as the vena cava does not pulse, we are unable to learn 

235 See n. 190 above about this tag from Horace. 


from it that the vena cava does not originate from the heart. To the 
contrary, we learn that Galen’s description can be refuted. At the same 
time, I do not deny the liver the role of sanguification, which Galen 
attributed to it at such length. This agrees with Aristotle, though he 
stated that the spleen is also responsible for sanguification. 

I shall say nothing about the first organ in the development of 
the fetus; for although I could easily reject the opinion of others in 
many ways, I would introduce nothing that seems sound to me in 
every way, so obscure to me is everything about the development of 
the fetus, and full of doubts. Nevertheless I should like to have the 
reasons available for which Buccaferreo favored Aristotle in the argu¬ 
ment about sanguification, since he learned from me the arguments 
which I have now proposed while dissecting. These relate to some¬ 
thing besides the fabric of the parts, and therefore here too I shall not 
enter into the dispute where Galen says the stomach is nourished 189 
by supplying its own juice which it prepares to the intestines; the liver 
and all the parts move the material brought to them in such a way that 
they eventually remove the excess and what is unfit for their nutrition. 

I believe quite different faculties and actions are present in the parts 
by which they attend to the nourishment of their own body and 
by which they serve the body as a whole; I take my argument espe¬ 
cially from the uterus and the heart, or even from the bladders and 
intestines. But because I could not extricate myself here with a short 
explanation, I shall move along to other topics which it will suffice to 
note down in three or four words. 

An example is the reasoning of Galen in which he affirms that 
the right kidney is higher than the left because of the directness and 
ease of attraction . 236 This is not to say that we now and then observe a 

236 In Fabrica V ch. 10 Vesalius objected to Galen’s claim, citing book 5 of De usu 
partium. In his sixth chapter Galen discusses why one kidney is placed higher than 
another. The kidneys are at different levels, Galen says, because “if they had been 
placed on a line with one another each would prevent the other from attracting 
because it would pull in the opposite direction.” (3.367.8—11, tr. May 1968, 258). 

left kidney higher than the right, but why, I beg to ask, do we deter¬ 
mine that directness is different on the right side than on the left, 
especially when either side of the stem of the vena cava is equally 
embraced by the substance of the liver, and it is known to the student 
of true anatomy that the branches presented to the liver are brought 
from the front of the vein?You cannot imagine any way in which this 
difference could occur in the sides of the vena cava, unless perhaps 
one determined to impugn Galen were to propose that the greater 
portion of the liver stands to the left of the vena cava than to the right, 
taking his argument from the position and course of the vena cava. 
The often emphasized demonstration of Galen comes to mind which 
he claims is true and irrefutable, deducing with it that the glandular 
body positioned at the beginning of the neck of the bladder, admit¬ 
ting the insertion of the vessels delivering semen, does not generate 
semen. However, the ancients believed semen is only held by it (as 
can be inferred from their words), as we also observe in dissecting that 
190 in no part is there as much semen as in the glandular body itself. 
Galen’s demonstration is of this kind. If semen were produced in the 
glandular attendants , 237 castrated animals would desire its excretion. 
But they are seen not to desire it: therefore, it is quite evident that 
semen is not generated in them. How much this demonstration, as it is 
not exactly anatomical, falls short of Galen’s often repeated and cited 
demonstrations rather than those that are consistent with the truth, 
will finally be known to anyone who considers that Galen, even if that 
glandular body did generate semen, removed the material from which 
it is composed. Hence, material suited to be converted into semen 

The reason for the higher position of the right kidney is that “most of the branches 
of the vena cava [vv. hepaticae] which bring the blood from the convex part of the 
liver open at the right; and it is easier for every body with an attractive faculty to 
exert it in a straight line.” (3.367.16—368.1, tr. May 1968, 258). 

237 Lat . glandosis astitibus, vessels carrying sperm to the prostate gland. Vesalius’ term is 
derived from Herophilus’ TrapaordTca aSEVosiSsts (glandular assistants), which he 
found in Galen’s De usu partium (4.190.1 ff., tr. May 1968, 644). 


could be presented to this body by the seminal vessels which Galen, 
however, removes by castration, not noticing that a similar demonstra¬ 
tion, indeed a completely worthless and poorly constructed proof, 
can be put forward in this fashion about the testicles. If the testicles 
acted by generating semen, animals whose vein and artery delivering 
the material of semen had them tied off where they slip out of the 
great space of the peritoneum or were cut off in such a way that they 
remained in the scrotum, would seek the excretion of semen. But 
they do not seek it.Therefore the testicles do not function to generate 
semen, in the same way, no doubt, as if testicles were able to prepare 
semen without material. This is not what I say, as if I were to argue 
that Galen had wrongly assigned the function of the glandular body, 
but only so we could ponder the craft of demonstration. We are not 
unaware how castrated animals sometimes desire venery no less than 
boys, but in vain. 

When I inquired into the reason for the location of the breasts, 
it did not satisfy me in Galen when he stated from Aristotle’s opinion 
that they are located on the chest because nourishment is taken in 
other animals into the mane or the horns , 238 as if quadrupeds lack 191 
veins running beneath the breast bone and others through the front of 
the chest. It is also as if this reasoning were not hke the one in which 
we wrongly assert with the mob that a woman is the only animal 
except perhaps a mare that is subject to monthly purgations, because 
in those animals the surpluses are dissolved into horns, feathers, manes, 
or scales, just as if the stag and the ram did not have longer and larger 
horns or rather were the only ones of their species so equipped, or 
the lion were not more hairy than the lioness and the rooster better 

238 “In animals in which most of the residues in the upper parts of the body are used 
up in making horns, teeth of a large size, flowing manes, and other structures of 
the sort, it was natural for another useful residue to be collected in the region 
of the thorax. Accordingly, in these animals Nature moved the mammae down 
from the thorax to the abdomen,” etc. (Galen De usu partium 3.602.7—12, tr. May 



plumed than the hen. But because such matters have more to do 
with Aristotle’s problems 239 than with Galen’s anatomy, we should pass 
them over. 

Besides the fact that I should have liked Galen to have a better 
knowledge of the interval between the veins that go to the uterus 
and to the lower abdomen, he does not seem to me to have a correct 
understanding when he takes blood to the breasts from the veins coter¬ 
minous with the uterus, because there are no veins into which they 
could more readily unburden themselves. It should have been known 
to him how tiny those veins are which run upward and how thin, how 
great the size of the vena cava, and how direct its descent into the veins 
of the legs. There is also the swelling of the abdomen, which prevents 
the upward passage of blood; so far am I from wishing to state with 
Galen that the swelling and tightening of the abdomen aids the ascent 
of blood. These have more to do with probable and rhetorical propo¬ 
sitions than with anatomy, against which should be tested so many 
vivisections 240 that are misleading because they show the role of none 
of the intercostal muscles in opening the thorax or drawing the ribs 
together. If I were to undertake to explain these vivisections, this piece 
of writing would grow too far beyond my intention. However, as an 
example I shall at least recall one; no other vivisection in Galen is bet¬ 
ter known than the one used in De usu pulsuum, De placitis Hippocmtis 
et Platonis, and elsewhere, where he says that everything in the neck 
must be cut away by which the heart can communicate with the brain, 
whether it travels up from the heart or from the brain down. But if we 
think about this vivisection carefully, two arteries present themselves to 
us which empty into the first sinuses of the hard membrane, and then 

239 Not the pseudo-Aristotelian Problemata but Degenemtione animalium 728b 18 ff.:“... 
the human body does not possess the sort of parts to which the [menstrual] residue 
gets diverted, as other animals do: it has no great coat of hair all over the body, and no 
secretions in the form of bones, horns, and tusks.” (Loeb tr. by A. L. Peck, p. 107). 

240 Treated at length in the 19th chapter of Fabrica Bk. 7: “Some Remarks on 


from the series of cerebral vessels to the network [plexus choroideus] 
compared to the secundines [placenta] or outer wrapping of the fetus; 
these arteries deliver material from the heart, and in his cutting he 
separates them intact and whole. But many such errors occur else¬ 
where, which students of anatomy must examine closely if they wish 
to declare themselves Galenists (as we surely all should). For nothing in 
all the books of Galen seems difficult to me except in his anatomical 
works, in which Galen is seen to be quite assiduous. So when we are 
trained in the first disciplines we find few matters which will delay us 
in the reading of Galen except anatomy. 

How useful the annotations of Vesalius have been in Galenic 
anatomy, and how little they are to be needed hereafter 

I first began to put this to the test while preparing annotations on the 
anatomical works of Galen, for example from his inconsistent state¬ 
ments and variant descriptions of things, many of which I have men¬ 
tioned in this epistle; many descriptions are also considered having 
to do with the observation of names which he himself put in place. 
Likewise I have remarked upon differing kinds of bone structure, the 
enumeration of bones of the upper maxilla, the vertebra taken up on 
both sides , 241 the sacrum, the processes of the scapula, and primar¬ 
ily their names; the description of the humerus along its length; the 
numbering of the foot bones; the muscles of the eyelids, and of those 
that move the lower jaw; about the muscles of the hyoid bone; about 
the muscles moving the scapula, the forearm, : the wrist, and the 193 
fingers; about the eight that are ascribed to the abdomen; and about 
those that control motions of the thigh, lower leg, and toes. It would 
be easy enough to recount various opinions, and from that it would 
readily be known what Galen added since the first publication of De 

241 The twelfth thoracic vertebra, whose structure is uniquely intermediate between 
those above and those below. Galen, who relied upon animal specimens, had vari¬ 
ously said this was the tenth or the eleventh. 


usu partium and when he made use of the writings of other anato¬ 
mists rather than his own inspection of the matter, which Sylvius is 
seen to resent that I too have pointed out. If, I say, I have written 
an unjust book in undertaking this epistle to you, which betokens 
my friendship toward you and the pleasure I take in casual conversa¬ 
tion and discussion with you: whatever this is, I shall have written it 
with little trouble. I take a supreme pleasure in the memory of those 
things which I have learned with such drudgery and squalor, in return 
for which I deserve something far different from the calumnies of 
those who because this exertion did not turn out as well for them and 
the subject does not yield them a ready reputation, have spewed their 
bile upon me, being so noxiously irate with me because I do not agree 
with Galen and therefore do not withhold all faith from my eyes and 
my reason. 

It is interesting to me that as soon as Sylvius seemed to become 
a little milder in his letter, he added that he very much wished I had 
presented my argument more gently and in a different manner; here 
he had the suspicion that not everything in Galen was sound, and he 
therefore wrote that he wanted the things I believed need annota¬ 
tion in Galen to be added to his books, in the same way as Sylvius’ 
disciples annotate from my book, the ones he hopes to persuade to 
sharpen their pens against me (though he is the one who does so, 
and abuses the name of disciple). It is as if I could institute something 
better than a new description of the entire human body when every¬ 
body has fallen so short of it and Galen is so scanty in descriptions of 
things though he has written the densest books. I have yet to see how 
I could better have presented my studious labors so that everything 
could turn out as desired at absolutely no expense and spare enough 
to bring something into a common summary of my endeavors pro¬ 
portional to the slenderness of my talent. 

Sylvius urges that I distil my annotations of Galen well and at length 
(which I remembered as opportunity provided while reconstructing 
many passages in the first book of De anatomicis administmtionibus, in 


my chapter about the muscles moving the forearm ). 242 He assumes 
that because of my youth and hasty publication I have made some 
error in my book which I now regret, and that my present time of 
life, not free of a wife, children, or any care of private business, in the 
delightful company of friends, would be perfectly suited to writing 
about anatomy It was, in fact, no pleasure for me to turn over bones 
for hours on end at Paris in the Cemetery of the Innocents, or to 
go to look at bones at Montfaucon , 243 where once with a compan¬ 
ion I was nearly killed by so many murderous dogs, or let myself be 
locked out of Louvain by myself so I could take bones from a gibbet 
in the middle of the night to prepare a skeleton. I will no longer be 
a nuisance to judges to have people killed with one form of execu¬ 
tion or another or reserve them for this or that opportune time for 
our dissections. I will not keep warning all my students to be on the 
lookout when someone is to be placed in a tomb, nor will I now 
urge them to observe in what condition someone died under the 
care of teachers whom they attended to learn their craft (for which 
a welcome reward would eventually come to all). I will not store up 
in my room for weeks on end bodies taken from graves or given to 
public execution, nor will I surrender myself to sculptors or painters 
to be so vexed that often because of their peevishness I thought myself 
more hapless than the corpses who had fallen to my lot for dissection. 

All of these things my immature age easily and cheerfully endured 19S* * 
for the development of my craft and my passion to learn and advance 
our common interests. 

I shall pass over the hard work with which I taxed myself 
for at least three full weeks when those who were present while I 

242 Chapter 46 of Bk. II of the Fahrica refers more than once to defects in Galen’s 
description of these muscles in De anat. adm. In the 1555 edition, he promises 
these will be more fully explained “in my annotations to the Anatomical Works of 

243 Site of the principal gallows controlled by the kings of France, northeast of Paris. 

* In the 1546 edition, page 195 was misnumbered as 196. 


taught anatomy in Italy saw me in public dissections, though I once 
performed this task at three universities in a single year . 244 So if I 
put off writing until the present time, and now for the first time 
am undertaking a condensed version , 245 my anatomical efforts would 
not be in the hands of students; I do not know whether works will 
be presented by later generations from a boiled-down Mesue , 246 a 
boiled-down Gatinaria , 247 or a boiled-down De morborum differentiis of 
some Stephanus 248 and De causis morborum, De symptomatum differentiis, 
De symptomatum causis, a book about tables, or finally a boiled-down 
part of Servitors drug sellers . 249 

So far as concerns my Annotations which had grown into a huge 
volume, those along with a complete paraphrase of the ten books of 
Rhazes’ To King Al mans or 50 which I wrote much more carefully than 

244 Following the Geldric War that ended in September 1543 (see n. 223 above), 
Vesalius lectured at Padua, Pisa, and Bologna. 

245 A coctio or boiled-down version of the Fabrica’s critique of Galen corresponding 
to the condensed versions of Mesue, Gatinaria, and other authors for medical 

246 Mesue the Younger or Johannes son of Mesue (Masawaih al-Mardini), 10th-century 
Arabic author of Canones Generates, the subject of a commentary by Mondino 
de’ Luzzi (ca. 1270—1326). He was also valued in the West for his textbook on 

247 Marco Gatinaria (1442—1496), author of De curis egritudinum particularium noni 
Almansoris practica uberrima, published in 31 editions in three languages between 
1506 and 1539. Another work, Morborum internorum prope omnium curatio, brevi meth- 
odo comprehensa, appeared in five editions between 1545 and 1549. 

248 Stephanus of Athens (c. 550—622), the Byzantine philosopher and physician, wrote 
commentaries on Hippocrates’Aphorisms, Galen’s Therapeutics, Galen’s De morbo¬ 
rum differentiis, and a book on uroscopy. 

249 Abu al-Qa-sim al-Zahrawi (936—1013), known in the West as Albucasis, wrote a 
book on the preparation of medicines which was translated into Latin in 1288 by 
Simon of Genoa, Liber Servitoris de praeparatione medicinarum simplicium printed at 
Venice in 1471. “It was relied on by many generations of European apothecar¬ 
ies as a first-hand source of information on pharmaceutical processes.” (Sneader 

250 Rhazes’ Liber ad Almansorem, on which see n. 188 above.Vesalius’ continuing inter¬ 
est in this medieval Persian author (865—925) is one of several habits of mind that 
distinguish him from the Humanists who gave him his early training. 


my paraphrase on the ninth book which is in print, and the begin¬ 
nings of a book on the formulation of medications (into which I had 
gathered many medicines that I thought useful) — all these perished 
in a single day with all the books of Galen that I had used in learning 
anatomy and had stained in various ways, as usually happens. When I 
left Italy to enter the court, and the doctors whom you know made 
the worst criticisms of my book and of all the books that are published 
today to advance study, addressing the Emperor and other powerful 
men, I burned everything (intending in the future to have httle diffi¬ 
culty refraining from writing), though more than once I regretted my 
petulance and was sorry not to have stopped myself at the warnings of 
friends who were present. 

But concerning my Annotations I am for that reason quite 
happy that no desire to pubhsh them is likely to come over me 
(even if they were extant), since I could easily predict how hostile 
they would have made everyone to me even if so few matters at odds 
with the views of Galen have chanced to make their way into my 
book. They have aroused anger in so many critics and surrounded 
themselves with so many defenders of Galen after three years, and 
even before the publication of my book. In a word, I believe that 
having been prepared after so long an interval of time they will make 
common cause with students and will come out with more than a 
short epistle full of accusations and without explication of all the 
passages in Galen. 

Concerning the books of Galen I have nothing to lament, since 
they have chanced to fall into the hands of people who lacked the 
ability to distinguish bad things written in the margins from the good. 
I believe you know how many marginalia are made in the universities 
by teachers; as soon as we read something we write things in the mar¬ 
gins that later seem to us inept and ridiculous. For my part I can make 
the guess that I read out Galen’s De ossibus to students as many as three 
times before I dared to note any correction to Galen, while now I 



cannot sufficiently wonder at my stupidity that I so badly understood 
what was written and that I so cheated my own eyes. 

Because I had the greatest pleasure in making a paraphrase 
comparing the Arabs with Galen and other Greeks in the parts of 
medicine about which Rhazes wrote in each of the books of his 
treatise, I am grieved that this project is lost to me, especially for the 
sake of my grandfather Everard, 251 whose commentary on that work 
of Rhazes I believe is not without learning; his commentary on the 
first four sections of Hippocrates’ Aphorisms, and several mathematical 
works attest that he was a man of singular talent. I have heard more 
than once from my father, 252 of pious memory, that though Everard 
had begun to take the post of my great-grandfather Johannes 253 as 
physician to Mary, wife of the emperor Maximilian, he passed away 
before he was 36 years old. Johannes survived him by many years and 
taught medicine at Louvain at an advanced age that was not suited 
for court life. That his father Peter 254 was a doctor is known from 
his book on the fourth Fen of Avicenna and several books inscribed 
with his name that are found among volumes that my mother still 
saves. Among them we have all the books that were copied out at 
huge (but now useless) expense, which were familiar to the doctors 
of that time. The record of these parents and their memory was quite 

251 Everard de Wesalia (d. ca. 1485), physician to the Archduke Maximilian. See 
Spelkens 1961,67 and O’Malley 1964,25 f.,who doubts Vesalius’report here of his 
youthful death. 

252 Andries Van Wesele (b. ca. 1479), the illegitimate son of Everard Van Vesele and 
Marguerite s’Winters. He served as apothecary to Margaret of Austria and later 
Charles V. 

253 Johannes de Wesalia, born soon after the beginning of the 15th century (d. 28 May 
1476), father of Everard. The wife of Maximilian was Mary of Burgundy, whose 
son Philip was to be the father of Charles V. 

254 Peter Witing bore the ancestral surname before his son Johannes adopted the name 
of their native town,Wesel in Cleves, as his surname. O’Malley 1964, 21 describes the 
family history given here as “a mixture of fact and legend.”The five generations of his 
family recorded here by Vesalius may be summarized (1) Peter Witing; (2) Johannes 
de Wesalia; (3) Everard de Wesalia; (4) Andries Van Wesele; (5) Andreas Vesalius. 


pleasant and revered when I was at Nymwegen; at the ancient and 
celebrated Wesaha in Cleves where they originated I was able to see 
the tombs of the Witing family when because of the adverse health of 
B. Navagero 2 ” it was necessary to delay at Nymwegen so long after 
the departure of the Emperor. 

So far as concerns me, it was at no one’s urging that I had the 
task of boiling down my Annotations to Galen, though it can be 
inferred from what I have said here in response to Sylvius that they 
would have been by no means useless. They may perhaps have been 
exposed to condemnation because they would have revealed the neg¬ 
ligence in anatomy of many who have claimed a great name for them¬ 
selves in that field. In addition, I had showed in my annotations that a 
third type of disease, centered in a continuous loosening, 2 '’ 6 was cor¬ 
rectly reported by the ancients, differently from Galen, and that Galen 
faulted them undeservedly in this respect, as he often did in other 
ways. It was also shown that the ninth temperament was taken from 
Chrysippus, though Galen’s authority placed it elsewhere. 267 Certain 
divisions in medical art were also shown not to match the method of 
his own art. 

255 On whom see n. 11 above. O’Malley (1964, 21) understands this to mean that dur¬ 
ing his delay at Nymwegen Vesalius was able to make a side trip to Wesel. 

256 One of the three general bodily conditions (dryness, fluidity, and a mixed condi¬ 
tion) described by the Methodist sect, which Galen strenuously condemned. In his 
portrait used as the frontispiece of the Fabrica, the Epitome, and the China Root 
Epistle, the words OCYUS IUCUNDE ET TUTE, a variant of the Methodist 
motto TUTO CELERITER IUCUNDE, are shown carved on the table at which 
Vesalius is standing. The Methodist ideal was that every procedure should be “safe, 
swift, and pleasant” (viz. painless). 

257 Galen’s De temperamentis made the ninth temperament a steady mixture of warm, 
moist, cold, and dry. Chrysippus of Soli (ca. 279— ca. 206 BCE), the third head of 
the Stoic school of philosophy, wrote a treatise on psychology On the Soul, now lost 
except for fragments, which Galen criticized. 

* In the 1546 edition, page 198 was misnumbered as 199. 



There were besides other facts which this is not the place to 
recount, that prove it is not my habit to weave new garlands for myself 
from the boiled-down labors of others, or to bring forth works writ¬ 
ten by others dressed up with some splendor or another of diction 
or paraphrased (not to say made more obscure) as if they were my 
own. And what desire, I ask, could anyone have for the publication of 
his own lucubrations when there is nowhere a lack of people plot¬ 
ting to destroy the labors of others? Even England now shows where 
they have counterfeited the figures from my Epitome so obscurely and 
without skill in the engraving though not without expense: yet some¬ 
one brought it out in such a way that it would embarrass someone to 
believe it had been published that way by me. To take a single exam¬ 
ple, the course of vessels, which my friends know I drew myself in my 
book, was so distorted that I can see scarcely any evidence of my dil¬ 
igence. Moreover, everything in England 2 ’ 8 is hideously reduced out 
of proportion, though images of this kind can never be printed large 
enough. I wonder why those grossly incompetent imitators have not 
observed that while I publish a register of letters of privilege or rights 
granted to me I would much rather grant publishers permission to 
print my figures than have them badly imitated by others. Though I 
gladly wrote that at the time, I would now like to have the same thing 
said to all because I would prefer to suffer the greatest sacrifice of my 
private property and would more willingly furnish something for the 
elegance of an edition than to have things produced for me by my 
uncommon labor so hideously marred. Everyone will believe good 
editions so much better than to have new editions produced with 
more inflated titles and more authors. 

So may the Gods support my work, I must overlook no means 
199 by which I can otherwise resist those imitators and the people who 
lie in ambush against the efforts of others when they can clear their 
own nostrils of nothing new. 

258 See n. 4 above on the 1545 Geminus plagiarism published in London. 


In the meantime, be in good health and commend me to our 
common friends; have my letter together with yours given to them, as 
you will be glad to present them (if they ask it of you) with whatever 
labor you have spent in writing to me. 

Ratisbon, written the Ides of June, year of salvation 1546. 

Your most devoted 
Andreas Vesalius 



An Italian Treatise 

in which is investigated 


added here as it was sent 


FTEN it happens, my most 
learned Joachim, when I explain 
in a letter to you the method of 
administering and preparing the 
decoction of the China root, that 
mention is made of an Italian 
treatise which I am giving to you written out exactly as 
it was sent to our court by others, so you will know 
how much has come into my hands about this new and 
already famous medicament. Though thanks to my 
friends I have given it in Latin, I send it in Italian (as I 
received it) because I know you are not ignorant of this 
tongue. You will also by this means more exactly gauge 

the mind of the author 


(whoever this empiric was) and feel I have satisfied your request. I have 
little doubt, however, that it was translated from the Spanish, since I 
also have at hand a Spanish formula together with a method of boiling 
down and administering the trifling Sparta parilla. 

But the Spanish description is much shorter than the present 
Italian and more fragmentary, alien to the method of the art in other 


Method of Administering 
the Water of the China Root 
[ Translated by Francesca Tatarannij 

A purgation will be carried out at the beginning, middle, and end on 
the advice of the physician, who will take into account the condition 
of the patient. Twenty-four ounces of the root should be divided into 
twenty-four parts to make a fresh decoction every day. That which 
you will put to boil tomorrow, on the previous day cut into small 
pieces, the smallest possible, and put them in a little water, leaving 
them to soak until the next day. Then put this root and the infu¬ 
sion into a new pot and pour three pitchers of spring water into it; 
let it boil until a third has evaporated. The pot should be of a size to 
ensure that the boiling decoction does not overflow; it should always 
be covered so its potency does not escape. Once cooked and removed 
from the fire, it needs to be covered with large towels lest it cool off 
completely, and it needs to be made fresh every day because otherwise 
it would become acid. If the patient is unable to have physical benefit, 
add to each preparation of this water half of an eighth ounce of celery 
root cooked with this China root. 

The patient will take a large glass of this decoction hot early in 
the morning while staying in bed, and thereafter will remain covered 


in bed and try to sweat for the space of two hours: the more he 
sweats, the more benefit he will have. After becoming dry, he should 
get up and walk, keeping himself out of the wind and well covered 
with clothing, especially for seven or eight days, during which the 
body should be in motion. After eight days have passed, if he likes 
he will be able to go outside, keeping himself out of the wind and 
wearing warm clothes. Throughout the day when he wants to drink 
he should drink the aforementioned decoction, which needs to be 
tepid, the warmer the better. He should eat young poultry or capons 
boiled without salt. He must avoid vinegar and anything acidic for 
fourteen days; he will eat nothing roasted. He will be able to eat all 
kinds of preserves and quince jams made with sweetening; he will not 
eat dairy products, and he will eat quince jams after meals or other 
things that benefit the body, especially honey, which is the best thing 
one can eat and can be eaten at any time. Everything should be eaten 
in moderation, because it is judged that diet has as much benefit and 
effect as the decoction. One should not drink wine, broth, or anything 
else during the twenty-four days that the aforementioned root lasts, 
and for this time one needs to refrain from sex. Once all the water is 
cooked and the root administered, the small pieces should be set to 
dry in the sun or elsewhere where they can dry, and once they are 
dry they are cut into smaller pieces. Two ounces of these pieces are to 
be placed in the amount of water previously mentioned and made to 
cook as prescribed above. This water should be drunk another eight 
or ten days in addition to the twenty-four. If anyone who takes this 
decoction should have sores, he should place upon them nothing but 
towels soaked in the decoction and stay at home. Anytime he wants 
to go out he should put on some others that are not soaked and upon 
returning put the soaked towels back on. He will often bathe the sores 
with the decoction, which has been so effective on sores that it could 
be no better. 

He should not eat fish of any sort, though sometimes good 
fish is not forbidden. Thus if the patient is weary he may drink wine 


23 7 

diluted with the decoction, and they let him eat any food that gives 
nourishment. They generally forbid all the following things, such as 
women, vinegar, salt, ingredients containing acids, herbs, goat meat 
or he-goat, and rooster: all these things except roast meat, which they 
deny him for fifteen days. From seven days before then he will begin 
to feel great pain in the parts where he is sick, and the pain will go 
on increasing until the fourteenth or fifteenth day. Thereupon he 
will feel well, and the sores will be healed (God willing) because the 
virtue of this root is great, and the patient should make every effort 
to complete the treatment and drink the decoction very hot in the 
morning and tepid the rest of the time. He should make himself 
sweat, because the more he sweats the better he will feel, and the 
greater will he will have to eat.The more days he takes the decoction 
at the weight and measure stated above, the healthier he will stay and 
the more it will profit his body; it will purge the inner parts with¬ 
out making him spit: not through benefit of the body but through 
the special virtue that this root has. After seven days he will scarcely 
204 have any physical benefits, because the body must be aided with 
clysters, not those of pharmacists or their products, but only those 
made from chicory water or from borage, with rose oil, or in fact 
common oil with salt. He will follow this regimen for six or seven 
days. If it is seen that he has physical benefit, he will not leave off 
going outdoors but he will keep himself out of the wind and keep 
well clothed, as we have stated above. 



Albius, friend ofVesalius at Pisa, student of anatomy, p. 176. 

Marcantonio Belloarmato, jurist of Siena: pp. 173, 175. 

Buccaferreo, friend and student ofVesalius at Pisa, pp. 176,188. 

John Caius (1510—1573), accused of publishing an inferior expanded 
version of the Epitome: Preface p. 4. 

Francesco Campana, private secretary to Duke Cosimo: Preface 
p. 4; 175. 

Stephanus de Casala (named in Index as Stephanus Sala), surgeon to 
CharlesV: p. 36. 1 

D. Cavalius or Caballus, one-time physician to CharlesV: pp. 3,12,16. 
See Roth 1892,203 n. 3. 

D. Marzilius Colla, master of the Imperial horses: p. 36. 

Realdo Colombo, the unnamed “dabbler” on the medical faculty 
at Padua who believed he had discovered the vessel conveying 
black bile from the spleen to the stomach: p. 136. 

1 Huard and Imbault-Huard 1980, 15 lists Charles Vs medical staff as Cornelius Van 
Baersdorp, Vesalius, Petrus Lopez, Jacobus Olivarius, Gregorius Lopez, Gonzales 
Munoz, Simon Guadalupe, Stephanus de Bourgogne, and later Henri Ma Thys 


Janus Cornarius (c. 1500—1558), in 1546 was professor of medicine 
at Marburg, returning in that year to Zwickau.“Primarily a 
medical philologist who edited a number of classical medical 
texts including works of Hippocrates, Galen, Aetius, and Paul of 
Aegina and belonged to that group of physicians who, because 
of their strong and constant belief in the validity of classical 
authority, were naturally unsympathetic to Vesalius’s purpose.” 
O’Malley 1964, 456 n. 178: p. 178 bis, 179. 

Cornelius von Baersdorp, second in rank of the Emperor’s physicians 
pp. 12, 16. 

Cosimo de’Medici (1519—1574), Duke ofFlorence from 1537 to 1574, 
reigning Grand Duke ofTuscany from 1569, who offeredVesalius 
a post on the medical faculty at Pisa: Preface pp. 1, 5; pp. 40,140. 

D. de Bossu Jean de Henin-Lietard, (aka le Grand, 1499—1562): child¬ 
hood friend and Grand Equerry of Emperor Charles V, who 
made him Count de Boussu in 1555. Scion of an aristocratic 
family in Hainaut, Belgium; his castle was visited by CharlesV in 
1545 and 1554. pp. 17,26. 

Cardinal Doria: Girolamo Doria (1495—1558), son of Admiral Andrea 
Doria (1466-1560): p. 37. 

Johannes Dryander (1500—1560), professor of mathematics and med¬ 
icine at Marburg from 1535, author of Anatomia capitis humani 
(1536): pp. 177,178. 

Ioannes Eck, distinguished physician at Cologne, common friend of 
Johannes Dryander andVesalius: p. 177, 178. 

Anna van Egmont (1533—1588), referred to as Comitissa Egmondana : 

p. 141. 

Jean Fernel (1497—1558), who first used the word “physiology” to 
describe the study of bodily function (see Sherrington 1946). 
Recommended as a professor at Paris for the son of Joachim 
Roelants: p. 42. 

Leonhart Fuchs (1501—1556), humanist physician and botanist, 
author of the great illustrated herbal New Kreiiterbuch (1543). An 


admirer of Vesalius, in 1551 he wrote an epitome ofVesalius 
and Galen: p. 179. 

Jean Baptiste Gastaldo, a prominent patient who benefited from treat¬ 
ment with the China root: p. 14. 

Ioannes Guinter vonAndernach (JohannWinter, 1505—1574),Vesalius’ 
professor at Paris, 1534—1536. Translator into Latin of Galen’s 
De anatomicis administrationibus (9 vols., Paris 1531); author of 
Institutiones anatomicae (4 vols., Paris 1536), a standard work 
for physicians published with Vesalius’ emendations in 1538: 
p. 177 bis. 

Lord of Hallewyn, casuality of the 1544 Battle of Saint-Dizier: 
p. 176. 

Prospero Martello, Florentine patrician whose death was investigated 
by Vesalius: p. 175. 

Giovanni de’ Medici or Giovanni dalle Bande Nere, 1498—1526, father 
of Cosimo de’ Medici, famed for his exploits as a condottiero or 
mercenary military captain: Preface p. 7. 

Bernardo Navagero (1507—1565),Venetian ambassador to the imperial 
court from 1543, overseer of the university at Padua and friend 
ofVesalius. His illness at Nymwegen in 1546 was the occasion 
for Vesalius’ delay there until April 11, during which he wrote 
the Epistle on the China Root: pp. 11,197. 

Oliveri, member of the faculty of medicine at Paris: p. 42. 

Joannes Oporinus (Iohann Herbst), printer of the Fabrica in Basel: 
Preface p. 4. 

Prince of Orange: see Hallewyn. 

Ludovico Panizza, physician in Mantua and medical author: p. 37. 

Juan Bautista Recasulano, bishop of Cortona and ambassador from 
the duke of Florence to Charles V 1543—1545: Preface p. 6. 

Joachim Roelants (1495—1558), protomedicus at Mechlin, author of 
letter to Vesalius requesting information about the China root. 
An old and close friend of Vesalius; his son of the same name 
had gone to Paris to study medicine: pp. 11, 200. 


Ludwig Sanches, protonotary of the king of Sicily; pp. 17,29. 

Jacobus Scepperus, copier of the China Root Epistle, who delivered a 
copy to FranciscusVesalius: Preface pp. 3, 4. 

Jacobus Sylvius (Jacques Dubois, 1478—1555) lectured on medicine 
at the College de Treguier, Paris, outside the faculty of medi¬ 
cine after receiving his baccalaureate from the Paris faculty of 
medicine in 1531. After 27 January 1536, he became eligible 
to lecture for credit from the faculty of medicine, but was not a 
member of that faculty. Pp. 9, 41—46, 75, 95, 122, 127, 148—149, 
151-155,176-177,193-194, 197. 

JeanVasses of Meaux, dean and chief administrative officer of the fac¬ 
ulty of medicine at Paris (see O’Malley 1964, 37f.): p. 42. 

Franciscus or Franyo is Ves alius, younger brother of the anatomist and 
author of the preface to the China Root Epistle: Preface, p. 3. 

GerardVueldwick, medical colleague ofVesalius, expert on botanicals 
and leader of a legation to Turkey: pp. 19, 37—39. 

Antonio Zuccha, friend ofVesalius: p. 12. 



Abdominal muscles absurdly 
held by some in the role of 

a fleshy layer (56) 65 

Acetabulum: name applied to 

three things (89, 90) 107,108 

Acetabulum: name as 
understood by 

Hippocrates (89, 90) 106,108 

Acetabulum of an herb (89) 107 

Achyna (18) 22 

Acorus, hke the China root (19) 23 

Acromion: name (53, 54) 62 

Albius: student of anatomy (176) 207 

Anatomists, ancient: diligence 
poorly grasped by Galen 
(116,117) 140 

Anatomists of our age, famous: 
why unmentioned by 
Vesalius (177,178) 209,210 

Antonius Zuccha (12) 14 

Apium (celery) root (30, 31) 35 

Arabic doctors not entirely to 
be kept from the hands of 
medical students (46) 52 

Aristotle: defended by Averroes 

against Galen (184) 217 

Aristotle: Galen overly given 
to zeal for falsely 

criticizing (186) 219 

Aristotle: much more 

deserving than Galen in 
studies common to the 
two (144) 173 

Aristotle: opinions about the 

foot of quadrupeds (108) 129 

Aristotle: wrongly criticized by 
Galen (92,123,124,134) 


Arterial vein: orifice (126) 


Arterial vein: origin (185) 
Arterial vein: nothing at 
all common with the 


liver (187) 

Arterial vein: whether its 

orifice is lesser than that 
of the great artery 


[aorta] (144) 

Arterial vein [truncus 

pulmonalis] brought from 


the vena cava (126) 

Arteries: network at base of 


the brain (93) 



Arteries: several false descriptions 

in Galen (122,124) 147, 149 

Arteries: stem from the heart 

(183) 215 

Arteries, seminal [aa. 

testiculares ]: whether origin 
the same as veins (138) 166 

Arteries, series: places where 
it is learned that Galen did 
not dissect humans (69) 81 

Artery, carotid: its foramen 

unknown to Galen (148) 176 

Artery, carotid: not brought 

intact into the head (147) 176 

Artery, great [aorta ]: origin and 

distribution (185) 218 

Arthrodia [articulatio plana] (97) 117 

Articular disease: remedy from 

decoction of chamaedrys (36) 42 

Articular disease afflicts all 

joints of the body (16) 20 

Averroes’ defense of Aristotle 

from Galen’s calumnies (184) 217 

Axillary vein: partition into 
two trunks (75) 

Back, description of muscles 

moving (116) 139 

Back, function of muscles 
moving ignored by Galen 
(162,163) 193 

Belloarmato of Siena, 
jurisconsult: story of 
dissection by Vesalius (173) 205 

Bernardo Navagero,Venetian 

ambassador (11,197) 13, 231 

Bile: injection into stomach 

(175) 207 

Bladder: attachment to 

peritoneum (82) 97 

Bladder, human: not observed 

by Galen (82) 97 

Bladder, neck and urinary 

passage: narrowness (166) 195 

deBossu,D. (17) 20 

Bone functions: several errors 

of Galen (149) 175-176 

Bones: Galen taught 

descriptions of simian, not 
human (46,96) 53,115 

Bones, construction: 

differences (96, 97, 98) 115-118 

Bones, symphysis of (97) 116 

Bovine brains only, not human, 
inspected by Galen 
(92,93) 110,111 

Boys also sometimes desire sex 

(190) 223 

Breasts, location: reason 

misstated by Galen (190,191) 223 

Buccaferreo, argument on 
behalf of Aristotle on 
sanguification (188) 221 

Buccaferreo, student of 

anatomy (176) 207 

Calumniation: effort of 
many overly taxed by 
(178,179) 211,212 

Caper ( capparis ) root (20) 24 

Cartilage in younger people 

joins to form symphysis (97) 117 

Cartilage of radius separating ulna 
from wrist neglected by Galen, 

like others as well (105) 126 

Cartilages of upper ribs falsely 
described by Galen as 
osseous (53) 61 

Cartilaginous ligament of 

vertebrae (116,117) 140,141 

Castrated animals also 
sometimes have an 
appetite for sex (190) 223 

Cattle brains, not human, 
inspected by Galen 
(92,93) 110-111 

Cavalius, D., physician of 

Emperor (12,16) 15,20 


Cecum: difference between 

Charles, Emperor: what 

human and other animals (80) 


luncheon and supper he is 

Cecum in dogs and caudate 

accustomed to take (15) 


apes (80, 81) 


China root (18) 


Centaury, greater: root (38) 


China root: description (18 ff) 

22 ff. 

Cento, concourse of veins 

China root: form (19) 


named by Arabs (139) 


China root: less celebrated in 

Cerebellum, construction (146) 


Italy (13) 


Cerebellum, position and 

China root: method of 

shape (92, 93) 110- 


administration written in 

Cerebellum wrongly identified 

Itahan (200) 


as origin of many nerves (130) 


China root: movement and rest 

Cerebral ventricles, description 

of users; management of 



wastes (30) 


Cerebrum: careless description 

China root: no taste or odor (20) 


of vessels in Galen (127) 


China root: occasion for 

Cerebrum: consideration of 

writing about (11) 


ventricles (147) 175- 


China root: sleep and 

Cerebrum: convolutions made 

wakefulness of users (29) 


for sake of its nutrition (180) 


China root: too many benefits 

Cerebrum: has no bone in 

absurdly ascribed (21) 


man (99) 


China root: users should 

Cerebrum: membranes of 

employ in mild weather (27) 


ventricles (147) 


China root: what dietary plan 

Cerebrum: to what extent 

suits users (27, 28) 


continuous (146) 174- 


China root: what drinks useful 

Cerebrum: why Galen called it 

for users (29) 


double (180) 


China root: what kind should 

Chamaedrys, decoction (36, 37) 


be selected for use (19, 23) 


Chamaedrys, low oak (37) 


China root: what states of 

Charles, Emperor: has best 

mind suit users (31) 


health in occupations of war 

China root: whence imported (18) 22 



China root: where found (19) 


Charles, Emperor: joint disease 

China root: why such a small 

[gout] (14,37) 18,42 

quantity is boiled in so 

Charles, Emperor: respiratory 

much water (27) 


difficulty (15,28) 18,32 

China root: with what success 

Charles, Emperor: too many 

many have used (12 ff) 

14 ff. 

prescriptions by doctors in 

China root decoction: color (22) 


vain (37) 


China root decoction: easily 

Charles, Emperor: uses 

spoiled (24) 


decoction of both the 

China root decoction: in what 

China and Guaiac (12, 

ways it differs from Guaiac 

14-26) 15,18 


decoction (14) 



China root decoction: length 

Cornarius and Fuchs, quarrel 

of first use (32) 


between (179) 


China root decoction: method 

Cornarius someday to correct 

of preparing and taking the 

passages in Galen and 

first (23) 


Aristotle noted by Vesalius, 

China root decoction: method 

according to Dryander s 

of preparing and taking the 

testimony (178) 


second (33) 


Cornelius, D., physician of 

China root decoction: to 

Emperor (12,16) 15, 19 

whom it should most be 

Coronary vein: origin (127) 152- 


administered, and how (22, 23) 


Coronary veins: whether there 

China root decoction: use by 

are two (126) 


Emperor, method, degree 

Cosimo, Duke: eagerness to 

of usefulness (12,14,15, 26, 

make University of Pisa 

29) 14,15,17,18,19,30,33 

famous (140) 


China root decoction: use in 

Cosimo, Duke: generosity (8) 


bathing ulcers (34) 


Cosimo, Duke: goodwill 

China root decoction: users 

toward men of letters (5 ff.) 

8 ff. 

also troubled by sexual 

Cosimo, Duke: headlong fall 

tension (32) 


when still a child (7) 


China root, first decoction: 

Cosimo, Grand Duke of 

quantity to be prescribed, 

Tuscany, now again Patron 

and time of administration 

of failing disciplines (40) 


(24,26) 28 


Cuttlefish, acetabula of (90) 


China root, use: time of year 

Cyna (variant name of China) (18) 


less necessary to observe 

than with Guaiac (27) 


Dental cavity also neglected by 

Clavicle: found on ape as well 

Galen (100) 


as man and other animals (54) 


Dental roots, number: Galen 

Coccyx: difference in man and 

not accurate throughout (100) 


simians (49, 50, 51) 58, 59, 60 

Digital bones: Galen falsely 

Coccyx: Galen De usu partium 

said are solid (100) 


had no knowledge in 

Digital bones: not the same 

simians or in humans (52) 


shape as digits (105) 


Colon: curvature toward 

Digital joints: very large 

umbilicus omitted by Galen 

differences (105,106) 




Digital tendons (117—119,120) 

Colon: description (134) 160- 



Colon: extended only along 

Digits: flexor tendons (163) 


lower region of stomach, 

Digits: insertion of muscles 

never riding above it (134) 


moving wrongly given by 

Colon: has no part of 

Galen (106) 


mesentery in man (69) 


Digits: lateral motion not 

Colon: turn above spleen (81) 95 


observed by Galen (155) 



Digits of foot: tendons of 

muscles that move (66, 67) 77—79 

Doctor: work of the hand 

belongs especially to (39) 45 

Doctors: judgement of the 
lowest kind about those 
more learned (40) 45 

Doctors, family of: constant 
zeal towards supporters of 
letters (6) 

Doria, Cardinal (37) 42 

Dorsal medulla: beginning and 

connection to cerebellum (130) 156 
Dorsal medulla: origin (146) 175 

Dorsal medulla: wrappings (117) 140 

Dryander, letter to Ioannes 

Eck (177) 209 

Echina (variant name of China) (18) 22 
Egmondana, Countess (141) 169 

Enarthrosis (97) 116 

Englishman, a certain [John 
Caius]: incompetent 
imitation of Vesalius’ 

Epitome (4,199) 6—7, 232 

Epiphyses of bones: function 
misunderstood by Galen 
(149,150) 178,179 

Epiphyses of bones wrongly 

described by Galen (96) 115—116 

Epiplokomistai [possessing an 
omentum], why people so 
called (79) 92 

Esophagus: connection with 

great artery (130) 156 

Esophagus: foramen not the 
same as that of great artery 
(130) 156 

Esophagus: its own foramen 
in transverse septum (115, 

116) 138-139 

Esophagus: neither course nor 
location correctly described 
by Galen (131) 157 

Esophagus: whether narrower 

at connection to stomach (133) 160 
Euripides rashly criticized by 
Galen (109) 

Everard, grandfather of 

Vesalius, commentaries on 
Rhazes and Aphorisms of 
Hippocrates (196) 

Exotics foolishly preferred to 
domestics (20, 36) 

Eye, bovine: why displayed 
for inspection rather than 
human (157) 

Eye, colors: distinction in uveal 

tunic (157,158) 188-189 

Eye muscles counted by Galen 

after first six: function (157) 187 

Eyelids, muscles of: Galen 
inconsistent in describing 
function (156) 186 

Eyes, location: differs greatly 
in humans from Galen’s 
description (47) 53-54 

Faculty, specific and essential (22) 26 

Fat: difference between human 

and simian (55) 64 

Fat: human, layered beneath 

skin not observed by Galen (56) 65 
Fat: no human body without (55) 64 

Fat: placed between skin and 
fleshy membrane in man, 
ignored by Galen (79) 93 

Fat: why it is white (181) 213 

Feet: function of tendons 

moving toes (164) 194 

Feet in humans and 

quadrupeds: design (108, 

109) 129-131 

Femur: difference in simians 

and humans (63, 64) 74, 75 

Femur: muscles that move (121) 145 

Femur in quadrupeds 

proportional to ours (108) 129 






Fetal development: everything 

Functions & uses of parts: 

obscure and full of doubts (188) 221 

Galen not completely 

Fetal wrappings (142) 


perfect in describing (148 if.) 177 if. 

Fetal wrappings differ between 

dog and woman (143) 


Galen: Attic Greek (84) 


Fetus: veins & arteries peculiar 

Galen: Averroes’ defense 

to (82) 


against his criticisms of 

Fibers, description (145) 


Aristotle (184) 


Fibula longer than humerus (103) 124 

Galen: book De ossibus (55) 


Food, weight: to what 

Galen: certain divisions in 

extent judgement of 

medical art do not respond 

physician should be free in 

to his method (197) 


permitting to the sick (29) 


Galen: errors in anatomy (45) 


Foot: what is to be understood 

Galen: forgetful of himself in 

by name (107) 


describing series of vena 

Foot, human: distinguished 

cava through thorax (72) 


from hand by one bone (109) 130 

Galen: how much esteemed by 

Foot, human: not the longest 

Vesalius (145) 


as said by Galen, but 

Galen: inconsistent statements 

shortest (107) 


and enumeration elsewhere 

Foot, muscles moving: how 

by Vesalius of those 

they agree with Galen’s 

observed (192) 


account (64-68) 


Galen: loss by Vesalius of 

Foot of quadrupeds: proper 

anatomical works explained 

definition & where it 

with annotations made 

begins (107,108) 


while reading (195,196) 227- 


Foot of simian: how much 

Galen: nothing in his works is 

longer than human (67) 


difficult except anatomy (192) 


Forearm, extensor muscles: 

Galen: praise of (44) 


wrongly observed by 

Galen: ridiculous 

Galen (62) 


argumentation about 

Forearm, flexors: origin of 

glandular assistants (190) 


anterior muscle wrongly 

Galen: several arguments in 

described by Galen (121) 


anatomy that are not valid 

Forearm, muscles moving: 

(181 ff.) 213 If. 

description inconsistently 

Galen corrects himself 

given by Galen 

elsewhere (158,163) 189,193 



Galen De anatomicis 

Forearm, veins: variation in 

administrationibus : lost in 

many people (75,76) 


fire (159) 


Francisco Campana, secretary 

Galen De ossibus: description 

to Cosimo Duke of 

of nerves corresponds to 

Tuscany (6,175) 


simians not humans (77) 


Fuchs and Cornarius, mutual 

Galen De ossibus : how many 

wrangling (179) 


times read by Vesalius to 


students before he caught 
any error therein (196) 229 

Galen De usu partium: as 

elegantly written as full of 
errors (181) 213 

Galen did not dissect humans 
but instead of man taught 
study of other animals 
(46 ff.) 52 ff. 

Galen did not dissect humans 

but simians (7, 57) 10, 66 

Galen did not see inner veins 
hidden deep in human 
humerus (75) 89 

Galen excused rather than 

censured when it is learned 
descriptions pertain more 

to simians than humans (95) 114 

Galen highly valued by Italians 

(46) 52 

Galen in account of parts 
did not record everything 
correctly (95) 115 

Galen like a Prometheus 

invented fabric of body and 
use of its parts (181) 213 

Galen makes use of writings 
of other anatomists rather 
than inspection of the thing 
(193) 226 

Galen more dedicated to 

calumniating Aristotle than 
to dissection (186) 219 

Galen never saw anatomy of 

man (70) 82 

Galen not easily agreed with 
lacking excellent reasons 
(162) 192 

Galen observed fabric even of 

apes casually (47) 54 

Galen rashly criticized ancients 
because they dissected 
humans and not like him 
simians (93, 94 ff.) Ill ff. 

Galen sometimes contradicts 
himself (72,73,113, 
167,180,184,186) 84,85, 


Galen thoroughly understood 

knowledge of simian (52) 60 

Galen wrote much in anatomy 
that he never saw, and 
imagined only with false 
imagination (161) 191 

Gall bladder: size of two fists 

(175) 207 

Gall bladder: stones 

(174-176) 206-207 

Gallic disease: to what extent 
China root is useful for suff 
erers from (22) 26 

Games suited to users of China 

and guaiac (31, 32) 36 

GeldricWar (176) 

Gerardus Vueldwick: special 
interest in simple 

medicaments (37) 43 

Gerardus Vueldwick, D.: 
legation to Turkey 
(19,38) 23,43 

Ginger: often covered with 

glutinous earth (19) 23 

Ginglymus (97) 116 

Ginglymus less prone to 

dislocation than enarthrosis 
(106) 127 

Girl, age six: dissection of (139) 166 

Girl, another, hunchbacked: 

dissection of (141) 169 

Glandular assistant (87) 104 

Glandular body at beginning 
of neck of bladder does not 
generate semen as judged 
by Galen (189,190) 222 

Glandular body at orifice of 

stomach: function (172) 203 


Glandular body extended 
toward duodenum: 
examination (133) 159 

Glandules of throat (145) 174 

Greeks, misrepresentation of (95) 114 

Guaiac: China stupidly 

preferred by some (21) 25 

Guaiac: medications often 

added to (34) 39 

Guaiac, decoction: diet to be 

employed while taking (17) 21 

Guaiac, decoction: states of 

mind that attend users (31) 36 

Guaiac, decoction: time to 

administer (14) 18 

Guaiac, decoction: use by 

Emperor (14, 26) 18, 30 

Guaiac, decoction: ways 
it is superior to China 
decoction (18, 26) 22, 29-30 

Hallewyn, Seigneur de: organs 

inspected by Vesalius (176) 208 

Hand, oblique motion (155) 184 

Hard membrane, process (145) 174 

Head: intrinsic motion above 

first vertebra (152) 182 

Head, bones of: several untrue 
descriptions in Galen (98, 

99) 118,119 

Head, foramina: account (100) 120 

Head, motion: wrongly 

considered by Galen with 
entire neck (150) 179 

Head, motions: omissions by 

Galen in describing (159) 190 

Head, muscles moving: 
differences in man & 
simians (58, 59) 68, 69 

Head, muscles moving the: 
second pair [m. semisiinalis 
capitis] (94) 113 

Head, rotating motions (153) 182 

Heart: construction hastily 

treated by Galen (144) 172 

Heart: description of wrapping 
and base according to 
Galen (143) 171-172 

Heart: explanation of ventricles 

(180) 212 

Heart: function of ventricles, 
how understood by Galen 
(180) 212 

Heart: right ventricle missing in 

animals without a lung (186) 219 

Heart: wrapping (91) 109 

Heart: wrapping attached to 

septum (71) 83 

Heart, cervid: bony substance (53) 62 

Heart, human: has no bone (53) 61 

Heart, position: different in 
humans than in dogs and 
simians (91) 109 

Heart, position in humans 

unmentioned by Galen (92) 110 

Heart, tip: why thick and very 

fleshy (180) 211 

Hippocrates: Galen contrary to 

(124) 149 

Hippocrates: passage 

misunderstood by Galen 
(71,72) 83-84 

Hippocrates’ opinion regarding 
acromion given only to 
humans (54) 62 

Homer: a passage in (65) 76 

Honey, consumption: familiar 

to Emperor in winter (28) 32 

Honey, consumption: what 
kind suits users of China 
decoction (28) 32 

Horns in uterus: why said to 

be (85, 86) 102,103 

Human: difference from simian 
in distribution or course of 
vessels (69) 80-81 


Human foot: not the longest 

but the shortest (107,155) 128,185 

Humeral vein: error heretofore 

in origin (75,76) 88 

Humerus: consideration (54) 62 

Humerus: consideration of 
several muscles moving the 
(113,114) 136,137 

Humerus: inner and outer 

tubercle (103) 124 

Humerus: lengthwise 

description in Galen (54) 62 

Humerus: muscles moving the 

(160) 190 

Humerus: observation of veins; 

see also Forearm 87—89 

Humerus: wrongly said by 
Galen to be longest of all 
bones after femur (103) 123 

Hymen: name (140) 167 

Hymen: observation in girls 
and older women (139 ff., 

142) 166 If., 169 

Hyoid bone (102) 122 

Hyoid bone in man not seen 

by Galen (48) 56 

Hypolapathus grown as 

rhubarb in local gardens (38) 44 

Ioannes Eck, physician at 

Cologne (177) 209 

Ioannes Guinter, Dr.: praise of 

(177) 209 

Ioannes Medici: memorable 

deed (7) 9 

Ioannes Vesalius, physician of 
Maria, wife of Emperor 
Maximilian (197) 230 

Innocents, cemetery of, Paris 

(194) 227 

Intercostal muscles: none 
perform function of 
opening thorax and 

separating ribs from each 
other (191) 224 

Intercostal muscles: use 

unknown by Galen (161,162) 192 

Intestine, canine: described by 

Galen instead of human (81) 96 

Intestines: beginning in highest 

part of right side (132) 158 

Intestines, human: Galen 

believed resemble those of 
dogs and simians (81) 96 

Itahans: admiration for Galen (46) 52 

Jacob Scepper (3) 5 

Jean-Baptiste Gastaldo (14) 17 

Juan Bautista Recasulano (6) 

Kidney, right higher than left: 

how explained by Galen (189) 221 
Kidneys: construction 

incompletely explained by 
Galen (138) 165 

Knee, examination of joint: of 

what sort in Galen (107) 128 

Larynx, eight common muscles: 

misnumbered by Galen (112) 135 

Latrunculi, game of “robbers,” 

usefulness of (32) 36 

Ligament binding liver to 
transverse septum (82) 

Ligaments: description not 
observed by Galen in 
humans (60) 70 

Ligaments: material of, for 
what purpose given to 
muscle (156) 185 

Ligaments: several uses and 
functions not well assigned 
(156 If.) 185ft~. 

Ligaments: why white (181) 213 

Liver: description not true in 

Galen (135) 161-162 


Liver: function of 

sanguification (188) 221 

Liver: whether all veins are 

common to (187) 219 

Liver, division into fibers: 
whether Galen should be 
considered the author (135) 162 

Liver, hard swelling of (175) 

Liver, human: attachment to 

front of peritoneum (82) 97 

Liver, human: continuous body, 

not separated into fibers (81) 96 

Liver, human: not observed by 

Galen (82) 97 

Liver, lobes: surrounding 

stomach (81) 96 

Liver for some time not 
performing its function 
(174,175) 206,207 

Loosening, continuous (flux, 
fluidity): rightly made a 
third type of disease by 
ancients but not 

by Galen (197) 231 

Ludwig Panizza, Dr. (37) 43 

Ludwig Sanches, ruler of Sicily 

(17,29) 21,33 

Lumbar fleshes: opinion 

different from Galen’s (60) 70 

Lung: largest member of entire 

body (125) 151 

Lung, lobe or fiber of (70, 71, 

91,95) 82,83,109,114 

Marzihus Colla (36) 42 

Masseter muscle: Galen wrong 
about use and description 
(158) 189 

Maxilla: shortest in man (47) 54 

Maxilla, infantile: joined by 

symphysis from two bones (48) 55 

Maxilla, lower: can under no 
condition be separated in 
man (48) 55 

Maxilla, upper: Galen’s description 

not acceptable (101) 121 

Medications, book on 
formulations begun by 
Vesalius (195) 229 

Membrane adhering to 
surfaces of muscles, not 
observed by Galen (120) 144 

Membrane common to spleen 

and stomach (136) 163 

Membrane covering ribs, 

function (172) 203 

Membrane, fleshy (55, 56) 64 

Membrane, fleshy: difference 
between human, dog, and 
simian (57) 66 

Membrane, hard: sinuses (127) 153 

Membranes: why white (181) 213 

Memory of things acquired 
with great labor supremely 
pleasurable (193) 226 

Menstrual purgations in 

virgins: character (142) 170 

Mental states suitable for those 

using the China root (31) 36 

Metatarsal bones (105) 126 

Mondino: panniculus carnosus 

(57) 66 

Montfaucon, Paris (194) 227 

Moon, mountain of: muscle in 

palm of hand (119) 143 

Motion: question of how 
movement is lost while 
sensation remains, & the 
contrary (170) 201 

Muscle: definition in Galen 

(110) 131 

Muscle: flesh the principal 

substance (156) 185 

Muscle adducting scapula to 

chest (113) 135 

Muscle consisting of fleshy 
membrane, missing in man 
(160) 190 


Muscle falsely designated by 
Galen as author of arm 
motions (57) 66 

Muscle formed of fleshy 
membrane in armpit and 
side of thorax (94) 112 

Muscle implanted from scapula 

to hyoid bone (159) 190 

Muscle insertions wrongly 
observed by Galen (114, 

115,119) 137,138,143-144 

Muscle not by nature halfway 
between ligament & 
tendon (110) 132 

Muscle resembling a A 

(113,114) 136 

Muscle resembling monk’s 

hood (115) 138 

Muscle resembling monk’s 
hood observed by Galen in 
dogs not humans (58) 67 

Muscles: attached membrane 

unobserved by Galen (120) 144 

Muscles: common laryngeal 
wrongly numbered eight 
by Galen (112) 135 

Muscles: description of several 
in which Galen rashly 
criticized ancients (94) 112 

Muscles: differences in some 
between simians and 
humans (58, 59, 61, 62, 

63) 67-70,71-74 

Muscles: not all originate from 

a bone (112) 134-135 

Muscles: several simian falsely 
attributed by Galen to 
humans (57, 58) 66—69 

Muscles, description: several 
wrongly assigned use and 
functions (156 ff.) 185 ff. 

Muscles moving bones: 

whether they lack tendons 
(112) 134 

Muscles moving the back: 
several neglected by Galen 
(116) 139 

Muscles moving the head 
dissected by Galen only in 
simians (58, 59) 68 

Navagero: health entrusted to 

care of Vesalius (197) 231 

Nerve, portion of: less than a 

hgament (110) 132 

Nerve pair: whether second is 

harder than third (129) 155 

Nerve series: sometimes equal 

with veins and arteries (111) 133 

Nerves: distinction between 

tendon and ligament (111) 133 

Nerves: employed for animal 

force (156) 186 

Nerves: several false 

descriptions taken from 
Galen (128,129 ff.) 154 ff. 

Nerves: uses and functions not 
everywhere rightly assigned 
by Galen (169,170) 200-201 

Nerves, on dissection of: 
whether fragment 
should be attributed to 
Galen (78) 91 

Nerves, optic: foramen (129) 155 

Nerves, varieties: wrongly 

observed by Galen (77 ff.) 90 ff. 
Nun, dissection of (140) 167 

Nymphaea [water-lily]: 

formation (142) 170 

Nymwegen: monuments of 

Vesalius family (197) 231 

Occipital bone: difference 
between canine, simian, and 
human (47, 48) 55 

Olfactory organ: false opinion 

of Galen concerning (181) 213 

Olfactory organs (128) 154 

25 7 

Omentum: attachment to 

Phlegm, drainage: Galen’s 

colon (79) 


misconception (181) 


Omentum: not greater in man 

Phlegm, straining of (129) 


than in other animals (79) 


Pisa, University of: made 

Omentum in man: location 

famous by Duke Cosimo (6) 


different from simians (78, 

Pisanus, St.: cemetery at Pisa (140) 


80,133) 91-92,92- 


Plants: procreation from seed 

Oporinus: friendship and good 



feeling forVesalius (4) 


Portal vein: beginning (122) 


Oporinus, press: no small credit 

Portal vein: function 

gained from publication of 

everywhere not well 

Vesalius’ book (4) 


considered by 

Optic nerves, foramen of (129) 


Galen (169) 


Orange, Prince of: viscera 

Portal vein: series of branches 

inspected by Vesalius (176) 


different in man and simian 



Panniculus carnosus or fleshy 

Praxagoras (84) 


membrane (56, 57) 


Pregnant uterus: coitus (87) 


Patella harder than should be 

Pregnant uterus: nature of 

called a cartilaginous bone 

mouth (87) 




Princes: also claim power for 

Pectoral bone: compared to a 

themselves in medicine (16) 


sword (93) 


Prospero Martello, Florentine 

Pectoral bone: how it differs in 

patrican: account of 

dog & man (52) 


dissection by Vesalius (175) 


Pectoral bones: sometimes 

Pubhshing: unfortunates who 

three in man (52, 53) 


publish to satisfy themselves 

Penis: description wrongly 



given by Galen (83) 


Penis, muscles of (121) 


Quinquefoil: use in Gallic 

Penis of cattle described by 

disease (36) 


Galen (83) 


Peritoneum: function (171) 


Radius: articulation with ulna 

Peritoneum: some inaccurate 



descriptions of parts 

Radius: examination of 

contained (130 ff) 

156 ff. 

depressions in epiphysis; 

Peritoneum, contents: function 

muscles and tendons (120) 


everywhere given by Galen 

Regius morbus (jaundice): 

incorrectly (171, 172) 203-204 

anatomy of victims (175) 


Peritoneum, parts contained 

Remedies, new: no end of 

by: reasons why wrongly 

praise in certain quarters (14) 


perceived by Galen (78) 


Reticular plexus, description: 

Peter Vesalius, doctor (197) 


many errors by Galen (147) 


Phlegm, course of wrongly 

Reticular plexus of Galen 

observed by Galen (101) 


(101,127) 121,153 

Rha of Dioscorides: description 

Seminal vessels, entry into 



uterus (86) 


Rha of Dioscorides or true 

Sesamoid ossicles overlooked 

rhapontic, much used in 

by Galen (106) 


Gallic disease (38) 


Simian foot much longer than 

Rhapontic, common (38) 


human (109) 


Rhazes, ten books To King 

Simian muscles: several falsely 

Almansor: how paraphrase 

attributed to humans by 

by Vesalius perished (195, 

Galen (57) 


196) 228-230 

Simian not human description 

Ribs: all nourished by azygos 

given by Galen in De ossibus 

vein in humans (73) 




Ribs: attachment (102) 


Simians thought too much like 

Ribs: whether all are 

humans in Galen (96) 


articulated to vertebrae 

Skull: artifice wrongly 

by two joints (49) 


observed by Galen (99) 


Ribs, true: osseous cartilage 

Skull: difference between 

only in the old (53) 


human and simian foramina 



Sacrum: difference in man, 

Skull: false descriptions of 

simian, and dog (49—51) 


contents in Galen (145) 


Sacrum: hollowed out for 

Skull, contents: basis for proof 

dorsal medulla (50) 


Galen did not dissect 

Scapula: muscles raising; two 

humans (92) 


are present in simians 

Skull, foramina: function not 

(94) 112-113 

understood by Galen (149) 


Scapula and its processes: 

Skull of a human not 

examination (53, 54) 


examined by Galen (48) 


Scapula, function of muscle 

Sparta parilla: administration (34) 


adducting to chest: 

Sparta parilla: description 

incorrectly known by 

(34, 35) 


Galen (113) 


Sparta parilla, decoction: 

Scapula, muscles moving the 

explained in Spanish (200) 


(160) 190-191 

Sparta parilla, definition; use in 

Scapulae: how muscles differ in 

Gallic disease (35) 


man and simians (49—51) 


Spleen: attachment to stomach 

Semen, excretion: whether 

unknown to Galen (83) 


cause of stimulation correctly 

Spleen: attachment with 

observed by Galen (179) 


stomach (136) 


Semen, whether both effective 

Spleen: function (172,173) 204-205 

and material cause of fetus 

Spleen: location (131) 




Spleen: sometimes performs 

Seminal arteries: whether 

function of liver 

origin is same as veins (138) 


(173,175) 205,207 


Spleen also responsible for 

sanguification (188) 221 

Stephanus Sala, surgeon to 

Emperor (36) 41 

Stomach: fills left side of body 

more than right (131,132) 157—159 
Stomach: location and shape 

(131) 157 

Stomach: no vein off shoots 

from vena cava (133) 159 

Stomach: substance of in 

orifices (133) 159 

Stomach: what is the fundus (132) 159 
Stomach, lower orifice: 

glandular body attributed 
to it does not control 

closing & opening (172) 203 

Stomach, orifice: whether 
it is correctly stated that 
the upper is closed by the 
transverse septum (172) 204 

Stomach, orifices: description 

(115,116,132) 139,158 

Suture between canine tooth 

and adjacent incisor (47) 54 

Suture of bones of upper 

maxilla (47) 53 

Sutures: course wrongly described 

by Galen even in simians (102) 122 
Sutures of upper maxilla: 

description (93) 111 

Sweat, how induced (25) 29 

Swiftness the greatest safety in 
war (5) 

Sylvius, Jacobus, finest of 

doctors of our time (41) 47 

Sylvius: disciples of whom are 
sharpening pens against 
Vesalius (193) 226 

Sylvius: letter of to Vesalius 

excusing errors of Galen (43) 49 

Sylvius: occasion for letter 
indicating nothing at all 
written in error by Galen (41) 47 

Sylvius: used as preceptor 
by Vesalius in reading of 
Galen’s De usu partium (151) 180 

Sylvius suspected not 
everything in Galen is 
correct (193) 226 

Symphysis (97) 116-117 

Synarthrosis: difference from 

diarthrosis (97) 116 

Synarthrosis: what Galen 

includes (96) 116 

Talus: what it is in quadrupeds 

(108) 129 

Tarsus, bones of (110) 131 

Temperament, ninth: taken 

from Chrysippus (197) 231 

Temporal bone: cavity missed 

by Galen (100) 119 

Temporal muscle: error of 

Galen regarding use (158) 189 

Tendon: difference from 

ligament (111) 133 

Tendon: nature & use of (112) 134 

Tendon concealed under skin 

of hand: description (117) 141 

Tendon hidden under sole of 
foot: difference in man and 
simians (64) 75 

Tendon of first two muscles 

moving foot: observation (65) 76 

Tendon of fourth muscle 

moving foot (65) 76 

Tendon of sixth muscle 
moving foot (66) 

Tendons: description of those 
not well examined by 
Galen (117-120) 140-144 

Tendons: difference between 
several in humans and 
simians (60, 61) 71 

Tendons: why white (181) 213 

Tendons of muscles moving 

toes (67) 78 


Terebinth: use (37) 


Tormentilla, use in Gallic 

Testicles: construction 

disease (36) 


carelessly described by 

Transverse septum, foramina of 

Galen (139) 




Thoracic cavity different in 

Triapharmacum (36) 


man, simians, and dogs (91) 


Thoracic vertebrae: 

Ulna, acute process: description 

connections (102) 


in Galen (154) 


Thoracic vertebrae: whether 

Umbilical vein (188) 


they lack transverse 

Umbilical vein: attachment for 

processes (154) 


human liver (82) 


Thorax, muscles that move: 

Urine: cause of voluntary 

difference in humans, 

retention (165) 


simians, and dogs (59, 60) 69—70 

Urine: in those using China 

Thorax, muscles that move: 

root (30) 


fourth (115) 


Urine: itch of saltiness (179) 


Thorax, muscles that move: 

Urine: muscles dedicated to 

function incorrectly 

voiding (165) 


observed by Galen (161) 


Uterus: acetabula of (89) 


Thorax, opening of: no 

Uterus: cavities and tunics of 

intercostal muscles perform 





Uterus: description of bovine 

Thorax, parts contained in: 

not human set forth by 

several untrue descriptions 

Galen (139) 


by Galen (143) 171- 


Uterus: fundus (86) 


Thumb: reason for flexion to 

Uterus: horns (85) 


middle of palm wrongly 

Uterus: length of neck [vagina] 

judged by Galen (61) 




Thumb, flexor muscles of 

Uterus: location, shape, 

ignored by Galen (68) 


attachments, substance, etc. 

Tibia, motions of: incorrectly 

(84,85) 99- 


observed by Galen (167) 


Uterus: septum of neck in girls 

Tibia, muscles moving (121) 




Tibia, muscles moving: 

Uterus: size of (88) 


difference in simians and 

Uterus: strangulation from 

humans (63) 


swollen ovaries (142) 


Tibia, muscles moving: 

Uterus: veins and arteries to (87) 


function wrongly described 

Uterus, human: difference 

by Galen (166,168) 196- 


from bovine (84—86) 


Tibia, sockets: incorrectly 

Uterus, human: length of neck 

observed by Galen (106, 

[vagina], from whence 



estimated by Galen (85) 


Tibia in quadrupeds (108) 


Uterus, human: not dissected 

Tongue, muscles of (121) 


by Galen (85) 



Uterus, nature of: 

consideration in Galen (84) 

Uterus, quadrupeds: neck 

extremely long (85) 101 

Uterus, veins of: how 

considered by Galen (191) 224 

Vein, from spleen into upper 
orifice of stomach: whether 
truly reported by others (135) 162 

Vein, unpaired [azygos]: 
different in man than in 
dog or simian (71, 72) 83—84 

Vein, unpaired [azygos]: 
incorrectly reported by 
Galen that it originates 
beneath heart (185) 217 

Vein, unpaired [azygos]: why 

so called (74) 86 

Veins: none except branches 
of portal vein inserted in 
stomach (133) 159—160 

Veins: several false descriptions 

in Galen (122 ff, 127) 147 ff , 152 
Veins, account of: Galen did 
not everywhere assign use 
& functions correctly (169, 

170) 200-201 

Veins, account of: Galen’s 
argument is rhetorical 

(187) 219-220 

Veins, of forearm and hand: 
most humans vary from 
one to next (75) 

Veins, origin: Galen’s 
arguments unsound 
(182) 213-214 

Veins, series: selected places 
by which it is learned 
that Galen did not dissect 
humans (69 ff.) 80 ff. 

Veins, series in arms and throat 

(127) 153 

Vena cava: beginning (122) 147 

Vena cava: branches falsely said 
are presented to stomach, 
omentum, or intestines (134) 161 

Vena cava: course different in 
man than in dog or simian 
(70,71) 82-83 

Vena cava: course through 

transverse septum (95) 114 

Vena cava: distribution to heart 

(126) 152 

Vena cava: falsely said by Galen 
to originate from liver but 
not from heart (182—185) 213—218 

Vena cava: orifice more than 
double size of orifice of 
aorta (144) 172 

Vena cava: size of orifice (184) 216 

Vena cava: stem and series of 

branches (122—125) 147—151 

Venery: to what extent 
prohibited to users of 
China root (32) 36—37 

Venous artery: origin (185) 217 

Venous artery: whether it 

meets the liver (187) 219 

Venus, garden of, or umbilicus: 

the herb (89) 107 

Venus, mount of in palm: 
meaning for chiromancy 
(60) 71 

Venus, mount of made up of 

six muscles (119) 143 

Vertebra, cervical, seventh: 
transverse processes always 
perforated (48) 56 

Vertebra, thoracic: tenth 
does not lack transverse 
processes (48—49) 56—57 

Vertebrae: among smaller 

bones (96) 115 

Vertebrae: ligaments or 

attachments, and cartilage 
(117) 140 

Vertebrae: membranes of (117) 140 


Vertebrae: unanatomically 

Vesalius’ Fabrica not taken from 

classed with ginglymus by 

writings of others (198) 


Galen (98) 


Vesalius’ forebears: largely 

Vertebrae, lumbar: lack a 

famous for study of 

particular process (49) 


medicine (197) 


Vertebrae, thoracic: eleventh 

Vesalius’ Epitome : clumsy 

and twelfth do not lack 

plagiarists in England (198) 


transverse processes (49) 


Vesalius’ Epistle on venesection 

Vesalius: considered it better 

in the forearm for lateral 

to write new account of 

disease (170) 


human body than make 

Vesalius’ letter to Sylvius: 

some annotation on Galen 

occasion for recording 



here (45) 


Vesalius: destruction of 

Vesalius’ Paraphrase in ten 

annotations to Galen, etc. (195) 


books of Rhazes’ Liber ad 

Vesalius: how great his zeal for 

Almansorem (195,196) 


anatomical research (194, 

195) 226,227 

Water: best kind for China 

Vesalius: medical student of 

decoction (23, 24) 


Sylvius (42) 


Weight, calculation of: in 

Vesalius: offered stipend of 800 

prescribing remedies not 

crowns by Tuscan Duke 

always the same, and how 

Cosimo (40) 


varied (28,29) 


Vesalius: used no preceptor in 

Wesalia a city of Cleves, where 

anatomy (177) 


Vesalius family originated 

Vesalius: when he remembers 



his notes on Galen 

Witing family tombs (197) 


(194) 226- 


Women: why unlike other 

Vesalius, family of: gained 

animals they have monthly 

no small credit from 

purgations (191) 


publication of Fabrica (4) 


Wormlike processes of brain: 

Vesalius’ annotations to 

function incorrectly stated 

Galen: what things were 

by Galen (181) 


principally dealt 

Wrist bones (105) 


with (197) 


Wrist bones porous, and 

Vesalius’ annotations to Galen’s 

filled with marrow (105) 


anatomy: how useful they 

Wrist joint only to the 

were and how little to be 

radius described by Galen 

needed hereafter (192) 




Vesalius’ De human corporis 

Wrist joint with bones of the 

fabrica: nothing found that 

forearm (103) 


should be changed after 

Wrist muscles: function 

many anatomies since 

incorrectly observed by 

publication (176) 


Galen (164)